To evaluate factors associated with posterior migration of intracameral air/gas into the vitreous cavity following Descemet membrane endothelial keratoplasty (DMEK). This retrospective case series included 30 eyes of patients with posterior chamber intraocular lenses (PCIOLs) and 11 eyes of patients with scleral-fixated intraocular lenses (SFIOLs) who underwent DMEK surgery. Preoperative variables potentially associated with posterior air/gas migration were recorded, including the type of intraocular lens, anterior chamber depth (ACD), pupil diameter, intraocular pressure (IOP), history of pars plana vitrectomy (PPV), and presence of iris defects. Preoperative and postoperative corrected and uncorrected visual acuity levels were assessed for all patients. Graft detachment and subsequent rebubbling were documented. Age, ACD, IOP, and preoperative and postoperative best-corrected visual acuity (BCVA) were similar between the groups (p > 0.05). The mean pupil diameter was significantly larger in the SFIOL group than in the PCIOL group (P < 0.001). Overall, 9 eyes (22%) developed posterior air/gas migration, which occurred more frequently in the SFIOL group than in the PCIOL group (63.7% vs. 6.7%, p < 0.001). Air/gas migration was significantly associated with larger pupil diameter and prior PPV (p = 0.013 and p = 0.014, respectively). Posterior air/gas migration into the vitreous cavity appears to be an important contributor to graft detachment following DMEK. In this cohort, SFIOL implantation was strongly associated with postoperative air/gas migration. Larger pupil diameter and prior PPV were also significantly associated with air/gas migration.
Aydin et al. (Thu,) studied this question.