Pre-Operative Laser Peripheral Iridotomy Versus Intraoperative Peripheral Iridotomy in Descemet Membrane Endothelial Keratoplasty | ASCRS
Presentation
Pre-Operative Laser Peripheral Iridotomy Versus Intraoperative Peripheral Iridotomy in Descemet Membrane Endothelial Keratoplasty
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other
Author: Nichelle Warren, MD
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Purpose
To compare post-operative outcomes between pre-operative laser peripheral iridotomies (LPI) and intraoperative peripheral iridotomies (PI) performed in Descemet membrane endothelial keratoplasty (DMEK).

Methods
Retrospective cohort study assessing the rates of complications in DMEK utilizing pre-operative LPI compared to intraoperative PI. Complications include: graft detachment, rebubbling, graft failure, interface heme, uveitis, and cystoid macular edema. Three surgeons’ methods were evaluated. Two of which utilize pre-operative LPI, while the third performs intraoperative PI. Inclusion criteria include patients receiving DMEK for Fuch's dystrophy, pseudophakic bullous keratopathy, and iridocorneal endothelial syndrome. Exclusion criteria include patients with history of uveitis, glaucoma, and cystoid macular edema. Average follow-up for those included in the study was for 1 year.

Results
There is no statistically significant difference in the rates of graft detachment between pre-operative laser peripheral iridotomies and intraoperative peripheral iridotomies. There is also no significant difference in the incidence of pupillary block, uveitis, interface heme or cystoid macular edema.

Conclusion
In conclusion, pre-operative laser peripheral iridotomy and intraoperative peripheral iridotomy yield similar results. Therefore surgeons may feel more reassured that one method is not superior to another.
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This presentation is from the session "SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

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