Cornea最新文献

{"title":"Blue Dacryorrhea After Inadvertent Infiltration of the Lacrimal Gland During Scleral Tattooing.","authors":"Francisco J Bonilla Escobar, Joana Karanxha, Jessica A Kraker, Lynn Hassman, Amit Reddy, Alan G Palestine","doi":"10.1097/ICO.0000000000004165","DOIUrl":"10.1097/ICO.0000000000004165","url":null,"abstract":"<p><strong>Purpose: </strong>To report a novel complication of scleral tattooing: inadvertent lacrimal gland infiltration leading to dacryoadenitis and pigmented dacryorrhea.</p><p><strong>Methods and results: </strong>A case report of a 25-year-old woman who presented to the emergency department with persistent unilateral eye pain, photophobia, and a history of bright blue tears 4 months after undergoing a scleral tattooing procedure. Diagnosis was confirmed via clinical ophthalmological examination and contrast-enhanced orbital computed tomography (CT). Examination revealed teal tattoo pigment within the palpebral lobe of the ipsilateral lacrimal gland, which was enlarged and tender, consistent with dacryoadenitis. Pigment was also noted in the limbal vasculature. Orbital CT confirmed anterior globe pigment deposition without evidence of globe penetration, cellulitis, or abscess. The patient's symptoms resolved with a conservative management strategy of topical antibiotic-steroid drops and lubrication.</p><p><strong>Conclusions: </strong>This case expands the known spectrum of scleral tattoo-related complications to include lacrimal gland involvement and pigmented tearing. It demonstrates that severe adnexal morbidity can occur even in the absence of globe penetration. Ophthalmologists should be aware of this potential complication and carefully examine the lacrimal system in patients with a history of ocular body modification. This report underscores the substantial risks of scleral tattooing and reinforces the need for patient counseling against the procedure.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1437-1445"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Surface Toxicity of Antibody-Drug Conjugates: Pathogenesis, Diagnosis, Grading, and Treatment of Ocular Adverse Effects.","authors":"Winston D Chamberlain, Clara C Chan, Amy Lin, Karolinna M Rocha, Beeran Meghpara, Sumitra Khandewal, Michelle K Rhee, Zachary Z Zavodni, Sumit Garg, Marjan Farid, Naveen K Rao","doi":"10.1097/ICO.0000000000004122","DOIUrl":"10.1097/ICO.0000000000004122","url":null,"abstract":"<p><strong>Purpose: </strong>The American Society of Cornea and Refractive Surgery Cornea Committee convened to create a brief review of the literature and expert experience of antibody-drug conjugates (ADCs) and their impact on ocular surface health.</p><p><strong>Methods: </strong>Peer-reviewed publications from 2003 to 2025 were evaluated. The information along with authors clinical experience was used to create a white paper on the current aspects ADC therapy that is relevant to the ocular surface health.</p><p><strong>Results: </strong>There are currently 14 Food and Drug Administration-approved ADCs. By most recent estimates in the literature, there are more than 200 ADCs currently in development, and a significant proportion of them are associated with keratopathy that has unique ocular surface manifestations. Features of ADC-induced keratopathy include corneal pseudocysts, superficial punctate keratitis, refractive shifts, and conjunctival hyperemia. More severe adverse events such as conjunctival hemorrhage, conjunctival scarring, and corneal ulcers are rare. These findings correlate with change in visual acuity and visual quality. Eye care providers need guidance to recognize, understand, and communicate critical features of vision health with referring oncologists.</p><p><strong>Conclusions: </strong>Given the anticipated surge in oncology patients on ADCs, there is a need for dissemination of information on ocular surface concerns. This review covers key aspects ADC toxicity mechanisms and pathological features on the ocular surface health including strategies to diagnose, grade, and treat disease. It also provides expectations on the eye care provider's role in communication with referring oncologists.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1339-1350"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Genetic Architecture Between Psychiatric Disorders and Keratoconus: Insights From a Large-Scale Genome-Wide Cross-Trait Analysis.","authors":"Gangyi Li, Yuke Wang, Wei Wang, Tengyue Liu, Enoch Obeng, Shuangle Li","doi":"10.1097/ICO.0000000000004047","DOIUrl":"10.1097/ICO.0000000000004047","url":null,"abstract":"<p><strong>Purpose: </strong>The correlation between keratoconus (KC) and psychiatric disorders has been reported, but whether there is a genetic correlation between the 2 remains unclear.</p><p><strong>Methods: </strong>We identified genetic overlaps between KC and 6 psychiatric disorders by using comprehensive summary data from genome-wide association studies. Cross-trait pleiotropic analysis uncovered shared loci and genes, whereas functional annotations and tissue-specific investigations assessed the impact of these pleiotropic genes. Finally, bidirectional Mendelian randomization was applied to explore causal relationships.</p><p><strong>Results: </strong>Significant genetic correlation and genetic overlap were observed in 3 of the 6 trait pairs. A multiplicity study using the composite null hypothesis discovered significant possible multiplicity single nucleotide variants across 3 trait pairs, revealing 13 pleiotropic genetic loci, of which 3 were confirmed as colocalized loci with a posterior probability (PP.H4) exceeding 0.75. Significantly, numerous pleiotropic loci were identified across various paired traits, including 11p15.5 and 9q34.3. At the gene level, 137 pleiotropic genes were identified, including PDDC1 , PIDD , and PNPLA2 . Gene-based analyses indicated that these genes were significantly enriched in the brain and fibroblasts. Pathway analysis highlighted critical roles in Wnt/β-catenin signaling pathway. Mendelian randomization analysis further analyzed the correlation between these diseases.</p><p><strong>Conclusions: </strong>This study offers additional evidence of a multifaceted relationship between psychiatric disorders, specifically attention-deficit/hyperactivity disorder, anorexia nervosa, and posttraumatic stress disorder, and KC. At the same time, it may facilitate novel medications and enhanced clinical treatment techniques.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1408-1418"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Graft Failure After Descemet Membrane Endothelial Keratoplasty: Clinical Characteristics and Ultrastructural Findings of Failed Grafts.","authors":"Julia M Weller, Thessalia Voulgari, Ursula Schlötzer-Schrehardt, Friedrich E Kruse, Nadja Gießl, Theofilos Tourtas","doi":"10.1097/ICO.0000000000004044","DOIUrl":"10.1097/ICO.0000000000004044","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical and ultrastructural characteristics of secondary graft failure after Descemet membrane endothelial keratoplasty (DMEK).</p><p><strong>Methods: </strong>Retrospective, single-center case series of eyes with failed DMEK grafts undergoing repeat DMEK between January 2014 and December 2023 at the Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. Potential risk factors for graft failure were correlated with the interval between the primary and repeat DMEK. Transmission electron microscopy (TEM) of excised Descemet membranes was used to detect ultrastructural alterations related to secondary graft failure after DMEK.</p><p><strong>Results: </strong>Among 6268 DMEKs, 156 cases (2.5%) met study inclusion criteria of secondary graft failure after an initial DMEK. Mean interval to repeat DMEK was 40 ± 30 months (range 5-132 months). Approximately 44% (n = 68) of eyes undergoing repeat DMEK had required air injections after the first DMEK because of graft detachment, compared with 10% in the primary DMEK cohort ( P < 0.001). Glaucoma was present in 33% (n = 51) of eyes with secondary graft failure compared with 8% of our primary DMEK cohort ( P < 0.001). Among the 51 glaucoma cases, 61% had primary open-angle glaucoma, 31% pseudoexfoliation glaucoma, and 8% chronic angle-closure glaucoma.TEM revealed the formation of a posterior collagenous layer more frequently in glaucoma eyes (92.5%) than in nonglaucoma eyes (76.5%). Posterior collagenous layer was significantly thicker in eyes with glaucoma.</p><p><strong>Conclusions: </strong>Eyes with secondary graft failure exhibited a higher prevalence of glaucoma and rebubbling procedures after the primary DMEK. TEM findings suggest that pressure-independent mechanisms might contribute to graft failure in glaucomatous eyes.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1392-1400"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus Induced Infectious Crystalline Keratopathy After Penetrating Keratoplasty.","authors":"Mehrnaz Atighehchian, Zahra Jafari, Siamak Zarei-Ghanavati, Sima Sheikhghomi, Mehran Zarei-Ghanavati","doi":"10.1097/ICO.0000000000004167","DOIUrl":"10.1097/ICO.0000000000004167","url":null,"abstract":"<p><strong>Purpose: </strong>To report a rare case of post-penetrating keratoplasty infectious crystalline keratopathy caused by Cytomegalovirus (CMV).</p><p><strong>Methods: </strong>The patient's history, clinical presentation, laboratory, and imaging analysis were reviewed.</p><p><strong>Results: </strong>A 55-year-old male patient was referred to our hospital with a medical history of 3 prior penetrating keratoplasty procedures because of post-refractive surgery infectious keratitis and epithelial downgrowth. He has been on both systemic and topical immunosuppressive medications. The patient presented with decreased vision, and on examination, a needle-like branching corneal lesions was identified, consistent with the diagnosis of infectious crystalline keratopathy. After negative results from smear and culture of corneal samples, molecular evaluation using polymerase chain reaction testing revealed the presence of CMV. Consequently, immunosuppressive therapy was adjusted, and systemic and topical antiviral treatments were initiated, resulting in a favorable clinical response.</p><p><strong>Conclusions: </strong>This case emphasizes the importance of considering CMV infection in progressive and nonresponsive infectious crystalline keratopathy to antimicrobial medications, particularly in immunosuppressed individuals. In addition, polymerase chain reaction is an appropriate laboratory molecular diagnostic test for the accurate diagnosis of CMV keratitis.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1446-1448"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes in Infectious Keratitis: A Systematic Review.","authors":"James Smith, Christian P Pappas, Maria Cabrera-Aguas, Himal Kandel, Stephanie L Watson","doi":"10.1097/ICO.0000000000004174","DOIUrl":"10.1097/ICO.0000000000004174","url":null,"abstract":"<p><strong>Purpose: </strong>Infectious keratitis has a profound impact on patients quality of life (QoL). Patient-reported outcome measures (PROMs) provide an invaluable method to capture subjective patient experiences and support practitioners in health care delivery. The primary and secondary objectives of this review were to systematically evaluate PROM tools used in infectious keratitis and evaluate the quality and content of PROMs in use for infectious keratitis.</p><p><strong>Methods: </strong>The protocol implemented for review was published in PROSPERO (CRD42023464686). A literature review was performed in PubMed, MEDLINE OVID, Embase OVID, Cochrane, Scopus, Web of Science, and PsycINFO in October 2023. Full-length studies, published in English, featuring named and externally validated PROMs which were used to evaluate QoL outcomes of patients with infectious keratitis, were included. Nonvalidated PROMs used in patients with infectious keratitis were excluded. Studies including but not explicitly defining corneal pathologies were also excluded. Psychometric quality, validity, and risk of bias of each PROM were assessed using previously validated criteria.</p><p><strong>Results: </strong>Eight studies evaluated PROMS in infectious keratitis, with 8 different PROMs (1 generic, 7 ophthalmic but not keratitis-specific) used. Patients with infectious keratitis demonstrated impaired QoL in all PROMs, domains representing vision and visual function most impaired. Dependence, mobility, and mental and emotional state were also affected. Only 1 paper (13%) used psychometric analysis to validate the PROMs before use.</p><p><strong>Conclusions: </strong>Infectious keratitis has a negative impact on patient's QoL, across multiple domains. A variety of PROMS have been used to assess QoL in keratitis with most awaiting validation for infectious keratitis.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1456-1466"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI Safety of Iron Oxide-Containing Pigments in Keratopigmentation.","authors":"Alexander Movshovich, Donald J D'Amico, Rigoberto Vazquez, Douglas Ballon, Aleksey Gokadze, Lana Evseeva, Jonathan P Dyke","doi":"10.1097/ICO.0000000000004199","DOIUrl":"10.1097/ICO.0000000000004199","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the magnetic resonance imaging (MRI) safety of iron oxide-containing pigments previously used in femtosecond laser-assisted keratopigmentation (KTP).</p><p><strong>Methods: </strong>Twelve pigment formulations were initially screened using MRI to identify the most magnetically reactive sample. Standardized pigment amounts equivalent to clinical use were measured with a precision microbalance. Temperature changes were monitored with fiber optic thermometry in porcine corneas with and without pigment after femtosecond laser tunnel creation during a standard MRI protocol. Pigment motility was assessed by suspending impregnated filter paper in MRI-safe glass jars and observing potential movement within the bore. MRI sequences were analyzed for image distortion.</p><p><strong>Results: </strong>No measurable temperature increase was observed in pigment-containing or control porcine corneas during MRI exposure. No pigment movement was detected; the impregnated filter paper remained stable without displacement, deflection, or torque. MRI revealed a localized signal at the pigment site, causing mild distortion limited to the corneal region, with no interference in adjacent or posterior ocular structures.</p><p><strong>Conclusions: </strong>Iron oxide-containing pigments (Biotic Phocea, France) used in KTP did not cause heating, motility, or clinically significant imaging artifacts during MRI. Although localized corneal signal distortion was noted, it did not hinder the visualization of deeper eye tissues. These findings support the safety of MRI in patients with prior KTP using iron oxide pigments, including those who had initial pigments implanted.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1427-1431"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Rose Bengal Photodynamic Therapy for Severe Infectious Keratitis.","authors":"Ruth Eskenazi-Betech, Gustavo Ortiz-Morales, Guillermo Raul Vera-Duarte, Luis Haro-Morlett, Angelica Hernandez-Solis, Miguel Juarez, Diego Zamarron, Jehu Lopez, Tatiana Fiordelisio, Alejandro Navas, Arturo Ramirez-Miranda, Enrique O Graue-Hernandez","doi":"10.1097/ICO.0000000000004035","DOIUrl":"10.1097/ICO.0000000000004035","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical outcomes, microbiological profile, and efficacy of Rose Bengal photodynamic therapy (RB-PDT) as adjuvant treatment in patients with severe infectious keratitis (IK).</p><p><strong>Methods: </strong>Prospective, noncontrolled, interventional study. Severe IK was defined as meeting ≥2 of the following: central ulcer, infiltrate ≥3 mm, presence of corneal melting or hypopyon, and lack of clinical improvement with conventional medical treatment. Clinical success was defined as avoiding a therapeutic keratoplasty (TPK).</p><p><strong>Results: </strong>A total of 21 eyes from 21 patients underwent RB-PDT. Clinical success was achieved in 61.9%. The mean follow-up was 9 ± 3.33 months (range: 4-15). Cultured samples were positive for 27 total microorganisms, including Fusarium spp (n = 12, 44.44%), S. epidermidis (n = 4, 14.81%), Acanthamoeba (n = 2, 7.40%), Pseudomonas spp (n = 3, 11.11%), and others. Cultured samples were grouped into bacterial (44.44%), fungal (48.14%), and polymicrobial (if cultured for multiple microorganisms, 28.57%) categories for analysis. Corneal melting (57.14%), hypopyon (57.14%), and fung-ball (38.1%) were present at the initial visit. The mean time from onset to clinical success was 89.69 ± 56.59 days. In cases of clinical success, the mean time from RB-PDT to clinical success was 46.69 ± 19.47 days. There was a total of 16 additional interventions, including evisceration (2), optical penetrating keratoplasty (5), conjunctival flap (3), amniotic membrane transplant (1), and topical losartan therapy (5). Clinical variables associated with clinical failure included diabetes and fung-ball at presentation.</p><p><strong>Conclusions: </strong>RB-PDT shows potential as an adjuvant therapy for managing severe infectious keratitis. TPK was avoided in 61.9% of cases.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1351-1359"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors, Treatment Outcomes, and Isolate-dependent Differences of Candida Keratitis.","authors":"Jerry Hsu, Darlene Miller, Sander Dubovy, Eduardo Alfonso, Guillermo Amescua","doi":"10.1097/ICO.0000000000004152","DOIUrl":"10.1097/ICO.0000000000004152","url":null,"abstract":"<p><strong>Purpose: </strong>To describe risk factors, clinical presentations and treatment outcomes of Candida keratitis and to identify isolate-specific characteristics of Candida albicans compared with Candida parapsilosis .</p><p><strong>Methods: </strong>Patients with Candida keratitis over a 10-year period were analyzed in a retrospective single-center chart review. Data collected included demographic information, ocular history, clinical characteristics, treatment history, and microbiology data.</p><p><strong>Results: </strong>Seventy-three consecutive cases of Candida keratitis in 69 patients were identified, including 31 cases of Candida albicans and 29 cases of Candida parapsilosis . There were fewer cases presenting from June through September. By year, there were no clear trends in number or type of Candida isolates. Topical steroid use (80.8%), history of corneal transplantation (47.9%), recent ocular surgery (38.4%), contact lens use (37.0%), ocular surface disease (32.9%), and preceding or concurrent bacterial coinfection (27.4%) were the most common identified predisposing risk factors. Approximately 90.4% (n = 66) had two or more predisposing factors. Of the seven remaining cases, bacterial coinfection was the sole factor in three cases. Compared with Candida parapsilosis , Candida albicans demonstrated higher rates of hypopyon formation (45.2% vs. 20.7%, P = 0.044) and more frequently underwent therapeutic penetrating keratoplasty (45.2% vs. 13.8%, P = 0.011). All five isolates with antifungal susceptibilities available were susceptible to all antifungals tested.</p><p><strong>Conclusions: </strong>Candida is an opportunistic keratomycosis that occurs most commonly in predisposed eyes. Although both Candida albicans and Candida parapsilosis were similarly common in this study, Candida albicans may be associated with more severe disease compared with Candida parapsilosis .</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1419-1426"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival of Grafts up to 10 years After Descemet Membrane Endothelial Keratoplasty.","authors":"Sophie Elaine Dryander, Maria Della Volpe-Waizel, Andre M Trouvain, Warda Darwisch, Clara E Englisch, Louise M Menkene, Peter Szurman, Karl Boden, Berthold Seitz, Fabian Fries, Annekatrin Rickmann","doi":"10.1097/ICO.0000000000004036","DOIUrl":"10.1097/ICO.0000000000004036","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate graft survival and postoperative outcomes up to 10 years after Descemet membrane endothelial keratoplasty (DMEK).</p><p><strong>Methods: </strong>A retrospective analysis of 2521 DMEK cases assessed graft preparation, perioperative complications, and outcomes including endothelial cell count (ECC), visual acuity (VA), and central corneal thickness. Patients were grouped into successful DMEK (sDMEK; n = 2201) and those needing repeat keratoplasty (re-graft; n = 320).</p><p><strong>Results: </strong>The Kaplan-Meier estimated graft survival at 10 years was 0.86. Pseudophakic donors were more frequent in re-grafts ( P = 0.002; hazard ratio 1.74), although donor ECC and age were comparable. Preexisting glaucoma, glaucoma surgery, and pseudophakic bullous keratopathy were more common in the re-graft group (all P < 0.001; hazard ratio 1.47, 1.73, 1.78, respectively). Intraoperative graft preparation time and handling showed no significant differences. Postoperatively, re-graft cases had higher rates of rebubbling, graft flipping, and further surgeries (all P < 0.001). In sDMEK, VA and central corneal thickness improved significantly by 4 to 6 weeks and remained stable up to 10 years (n = 40; P = 0.84, P = 0.76). ECC decreased by 33% at 1 month ( P < 0.001) and by 47% at 10 years ( P = 0.18).</p><p><strong>Conclusions: </strong>This long-term analysis confirms DMEK as a durable and effective technique with stable visual outcomes. Although the overall success rate is high, patients with glaucoma or complex anterior segment conditions may experience reduced graft survival and increased endothelial cell loss.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1360-1367"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}