title: Large diameter descemet membrane endothelial keratoplasty in buphthalmic eyes.
abstract: OBJECTIVE
  To report the outcomes of Descemet membrane endothelial keratoplasty (DMEK) using a large diameter graft in the management of endothelial decompensation in buphthalmic eyes.
  
  
  METHODS
  Four eyes of 4 adults (1 man, 3 women) with bullous keratopathy and buphthalmos secondary to congenital glaucoma were treated with DMEK using posterior lamellar grafts with diameters ranging from 10 to 12 mm. The mean age was 31 (±9) years (range, 20-38 years). Mean follow-up time was 13.5 (±7.5) months (range, 6-24 months). Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, endothelial cell density, and complications after surgery.
  
  
  RESULTS
  In all eyes, there was improved corneal clarity with decrease in pachymetry. The final postoperative BCVA improved in most eyes. There was no significant change in IOP, with 3 eyes needing additional antiglaucoma medication. Endothelial cell loss ranged from 37% to 42%. Postoperative complications were early partial graft detachment in 2 eyes, one resolving spontaneously without intervention and the other requiring a rebubbling, and cataract formation requiring phacoemulsification in 1 eye.
  
  
  CONCLUSIONS
  DMEK using a large or even full diameter Descemet membrane graft may be an effective treatment for bullous keratopathy in buphthalmic eyes. Partial graft detachment after surgery may be the main complication. Postoperative IOP control is mandatory, and BCVA may vary with ocular comorbidity unrelated to the transplanted cornea.
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
authors.forename: Ruth
authors.initials: R
authors.lastname: Quilendrino
authors.forename: Ru-Yin
authors.initials: RY
authors.lastname: Yeh
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.forename: Lisanne
authors.initials: L
authors.lastname: Ham
authors.forename: Martin
authors.initials: M
authors.lastname: Dirisamer
authors.forename: Jaco
authors.initials: J
authors.lastname: van Niekerk
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D063171:Corneal Pachymetry; D003886:Descemet Membrane / Q000033:anatomy & histology*; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000033:anatomy & histology*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006871:Hydrophthalmos / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications; D014019:Tissue Donors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult