title: Comparison of 20% sulfur hexafluoride with air for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK).
abstract: To compare the effect of 20% sulfur hexafluoride (SF6) with that of air on graft detachment rates for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK).
  Forty-two eyes of patients who underwent DMEK by a single surgeon (A.S.J.) at Wilmer Eye Institute between January 2012 and 2014 were identified; 21 received air for intraocular tamponade and the next consecutive 21 received SF6. The main outcome measure was the graft detachment rate; univariate and multivariate analyses were performed.
  The graft detachment rate was 67% in the air group and 19% in the SF6 group (p<0.05). No complete graft detachments occurred, and all partial detachments underwent intervention with injection of intraocular air. The percentages of eyes with 20/25 or better vision were not different between the groups (67% vs. 71%). Univariate analysis showed significantly higher detachment rates with air tamponade (OR, 8.50; p<0.005) and larger donor graft size (OR, 14.96; p<0.05). Multivariate analysis with gas but not graft size included showed that gas was an independent statistically significant predictor of outcome (OR, 6.65; p<0.05). When graft size was included as a covariate, gas was no longer a statistically significant predictor of detachment but maintained OR of 7.81 (p=0.063) similar to the results of univariate and multivariate analyses without graft size.
  In comparison with air, graft detachment rates for intraocular tamponade in DMEK were significantly reduced by 20% SF6.
authors.affiliation: Tufts University School of Medicine, Boston, MA, United States.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Botsford
authors.affiliation: Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vedana
authors.affiliation: Oncology Center-Biostatistics/Bioinformatics, Johns Hopkins University, Baltimore, Maryland, United States.
authors.forename: Leslie
authors.initials: L
authors.lastname: Cope
authors.affiliation: Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Yiu
authors.affiliation: Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
authors.forename: Albert S
authors.initials: AS
authors.lastname: Jun
mesh_terms: D000368:Aged; D000388:Air; D003886:Descemet Membrane / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D058450:Endotamponade / Q000379:methods*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D013459:Sulfur Hexafluoride