Descemet membrane endothelial keratoplasty with or without overnight admission.

IF 2.8 3区 医学 Q1 OPHTHALMOLOGY
Eye Pub Date : 2025-03-25 DOI:10.1038/s41433-025-03754-w
Giulia Coco, Luca Pagano, Alfredo Borgia, Mahmoud Ahmed, Davide Tucci, Kunal A Gadhvi, Stephen B Kaye, Vito Romano
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引用次数: 0

Abstract

Objective: To compare visual outcomes and show postoperative complication rates of Descemet Membrane Endothelial Keratoplasty (DMEK) with or without overnight admission.

Methods: Retrospective analysis of DMEK surgeries performed at the Royal Liverpool University Hospital from 2018 to 2023. Data on demographics, surgical details, intraoperative and postoperative complications and admission type were collected. Visual outcomes and complication rates of surgeries with or without overnight admission were evaluated.

Results: 344 eyes were included with mean patients' age of 72.1 ± 9.7 years (range 37.4-96.6 years). After surgery, 61.3% of patients (n = 211) were hospital-admitted for a one-night stay while 38.7% (n = 133) were home-discharged on the same day. Intraoperative complications occurred in 8.7% of patients and postoperative complications in 5.8%, with no difference with or without overnight admission (p = 0.308 and p = 0.412, respectively). There was no difference in the improvement in visual acuity (0.43 ± 0.6 and 0.45 ± 0.6 logMAR; range: -1.82; +2.38 logMAR) between both groups (p = 0.984), and no difference was found in postoperative rebubbling rate between both groups (30.8% in hospital-admitted and 31.6% in home-discharged; p = 0.926). Multivariate logistic regression showed no association between overnight admission and DMEK rebubbling rate (p = 0.555). However, postoperative complications, triple procedure and recipient age were all significant factors increasing DMEK rebubbling requirement (p < 0.05). Home-discharged patients had a risk ratio of 1.03 (95% CI 0.74-1.41; p = 0.926) for rebubbling and 0.68 (95% CI 0.28-1.372; p = 0.412) for postoperative complications compared to their hospital-admitted counterpart.

Conclusions: Visual outcomes and postoperative complications did not show any significant difference in DMEK surgeries with or without overnight admission.

目的比较戴斯麦特膜内皮角膜移植术(DMEK)的视觉效果并显示术后并发症发生率:对2018年至2023年在利物浦皇家大学医院进行的DMEK手术进行回顾性分析。收集了有关人口统计学、手术细节、术中和术后并发症以及入院类型的数据。评估了入院过夜或未入院过夜手术的视觉效果和并发症发生率:共纳入 344 只眼睛,患者平均年龄为 72.1 ± 9.7 岁(37.4-96.6 岁)。手术后,61.3%的患者(n = 211)住院一晚,38.7%的患者(n = 133)当天出院回家。8.7%的患者出现了术中并发症,5.8%的患者出现了术后并发症,入院过夜与否无差异(分别为p = 0.308和p = 0.412)。两组患者的视力改善率没有差异(0.43 ± 0.6 和 0.45 ± 0.6 logMAR;范围:-1.82;+2.38 logMAR)(p = 0.984),两组患者的术后再发泡率也没有差异(入院患者为 30.8%,出院患者为 31.6%;p = 0.926)。多变量逻辑回归显示,入院过夜与 DMEK 反弹率之间没有关联(p = 0.555)。然而,术后并发症、三重手术和受术者年龄都是增加 DMEK 复泡要求的重要因素(p 结论:术后并发症和 DMEK 复泡要求之间没有关联:入院过夜与不入院过夜的DMEK手术在视觉效果和术后并发症方面没有明显差异。
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来源期刊
Eye
Eye 医学-眼科学
CiteScore
6.40
自引率
5.10%
发文量
481
审稿时长
3-6 weeks
期刊介绍: Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.
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