RT Journal Article
T1 Pupillary Abnormalities in Descemet Membrane Endothelial Keratoplasty After Nearly Full Tamponade
A1 Arnalich Montiel, Francisco
A1 Pérez Sarriegui, Ane
A1 Lauzirika, Gorka
A1 Porrua, Laura
A1 Hernández Verdejo, José Luis
AB Purpose: To describe the incidence, risk factors, and management of pupillary abnormalities after anterior chamber (AC) full air or gas tamponade in Descemet membrane endothelial keratoplasty (DMEK) without pupillary block.Methods: In this retrospective case series, clinical records of 25 patients (32 eyes) who underwent DMEK were reviewed for pupillary abnormalities and iris morphology. All patients had nearly full intracameral tamponade with air or 20% SF6 at the end of surgery without default air release postoperatively.Results: Pupillary abnormalities ranging from mild ovalization to mid-mydriasis were seen in 56% of the cases. These abnormalities were not related to morphometric changes in the iris volume, or in the iris dilator or iris sphincter muscle, but were probably due to posterior synechiae. Combining DMEK and cataract surgery increases by 5-fold the odds of developing this complication. Surgical revision of the posterior surface of the iris and synechiolysis reversed these pupillary abnormalities.Conclusions: Nonischemic pupillary abnormalities can be seen in patients with DMEK using a nearly full air/gas tamponade in the AC after surgery despite patent iridectomy especially when combined with cataract surgery. Ensuring complete mydriasis in the immediate postoperative period and a free-floating bubble in the AC above the inferior pupillary margin may reduce its incidence.
PB Wolters Kluwer Health
SN 0277-3740
YR 2017
FD 2017-03-01
LK https://hdl.handle.net/20.500.14352/18053
UL https://hdl.handle.net/20.500.14352/18053
LA eng
NO Received for publication October 15, 2016; revision received November 27, 2016; accepted November 29, 2016. Published online ahead of  print January 2017
NO Instituto de Salud Carlos III
NO Fundación Mutua Madrileña
DS Docta Complutense
RD 11 abr 2025