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To compare post-operative outcomes between pre-operative laser peripheral iridotomies (LPI) and intraoperative peripheral iridotomies (PI) performed in Descemet membrane endothelial keratoplasty (DMEK).
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.
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.
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.
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.