Impact of the Decemet Membrane Perforation on urgical Outcome After Deep Lamellar Keratoplaty Original Reearch Article

Purpoe To tudy the influence of the Decemet membrane (DM) perforation after deep lamellar keratoplaty (DLKP) on endothelial decompenation, endothelial denity, viual acuity, and potoperative complication. The relationhip between DM perforation and peudoanterior chamber formation alo wa tudied. Deign Retropective tudy. Method Ninety-ix conecutive eye of 89 patient who underwent DLKP with and without DM perforation were tudied. The eye with DM perforation were divided further into two group: macroperforation and microperforation. Main outcome meaure included graft urvival, potoperative peudochamber formation, endothelial denity, and bet pectacle-corrected viual acuity (BCVA). Reult Overall, 88 of 96 eye (91.7%) had clear graft. Endothelial decompenation developed in three eye (13.0%) in the eye with perforation, which wa ignificantly higher than in the eye without perforation (1.4%; P = .047). Potoperative peudochamber formation wa oberved in 60.0% in the perforated eye, which wa ignificantly higher than that oberved in the imperforated eye (19.7%; P = .0003). In the eye with perforation, mean endothelial cell denity wa ignificantly decreaed compared with that of the imperforated eye at three and ix month after urgery (P = .0497 and P = .0002, repectively). Three month after urgery, BCVA in the imperforated eye wa ignificantly better than that in the perforated eye (P = .016). Eye with macroperforation were more likely to develop both peudochamber and endothelial decompenation than eye with microperforation. Concluion Perforation of DM adverely affected endothelial decompenation and endothelial denity after DLKP, epecially in cae where perforation were large.