Incidence and management of early postoperative complications in lamellar corneal transplantation

Graefes Arch Clin Exp Ophthalmol. 2023 Nov;261(11):3097-3111. doi: 10.1007/s00417-023-06073-6. Epub 2023 Apr 27.

Abstract

Purpose: To provide a comprehensive review of the incidence, risk factors, and management of early complications after deep anterior lamellar keratoplasty (DALK), Descemet stripping automated keratoplasty (DSAEK), and Descemet membrane endothelial keratoplasty (DMEK).

Methods: A literature review of complications, that can occur from the time of the transplant up to 1 month after the transplant procedure, was conducted. Case reports and case series were included in the review.

Results: Complications in the earliest postoperative days following anterior and posterior lamellar keratoplasty have shown to affect graft survival. These complications include, but are not limited to, double anterior chamber, sclerokeratitis endothelial graft detachment, acute glaucoma, fluid misdirection syndrome, donor-transmitted and recurrent infection, and Uretts-Zavalia syndrome.

Conclusion: It is essential for surgeons and clinicians to not only be aware of these complications but also know how to manage them to minimize their impact on long-term transplant survival and visual outcomes.

Keywords: Complications; Corneal transplant; Deep anterior lamellar keratoplasty; Descemet membrane endothelial keratoplasty; Descemet stripping automated endothelial keratoplasty; Penetrating keratoplasty.

Publication types

  • Review

MeSH terms

  • Corneal Diseases* / surgery
  • Corneal Transplantation* / adverse effects
  • Descemet Stripping Endothelial Keratoplasty
  • Disease Management*
  • Global Health
  • Graft Survival
  • Humans
  • Incidence
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / therapy
  • Risk Factors
  • Visual Acuity