{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:19:16Z","timestamp":1784956756759,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"publisher","award":["03-2021-0400"],"award-info":[{"award-number":["03-2021-0400"]}],"id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Graft detachment is a common and significant complication in Descemet membrane endothelial keratoplasty (DMEK). We investigated the risk factors of graft detachment requiring rebubbling after DMEK using imported pre-cut donor tissues. The medical records of 48 patients who underwent DMEK for Fuchs\u2019 endothelial dystrophy (FED) or bullous keratopathy (BK) at Seoul National University Hospital were retrospectively reviewed. Donor, recipient, and surgical factors were evaluated using univariate and multivariate logistic regression models. Graft detachment requiring rebubbling occurred in 17 (32.7%) eyes. The detachment group exhibited older recipient age (<jats:italic>p<\/jats:italic> =\u20090.006), higher prevalence of diabetes (<jats:italic>p<\/jats:italic> =\u20090.001), and a higher proportion of FED (65%, <jats:italic>p<\/jats:italic> =\u20090.003). Notably, the detachment group demonstrated a significantly lower postoperative 2-h intraocular pressure (IOP) (<jats:italic>p<\/jats:italic> =\u20090.002) and a greater proportion of eyes with IOP &amp;lt;20\u2009mmHg (<jats:italic>p<\/jats:italic> &amp;lt;\u20090.001). Older recipient age (OR 1.08, 95% CI 1.02\u20131.17), diabetes (OR 23.8, 95% CI 2.61\u2013217), FED surgical indication (OR 6.19, 95% CI 1.74\u201322.0), lower postoperative 2-h IOP (OR 1.21, 95% CI 1.06\u20131.38), and postoperative 2-h IOP &amp;lt;20\u2009mmHg (OR 14.0, 95% CI 1.64\u2013119) were associated with increased odds of graft detachment. According to multivariate logistic regression, lower postoperative 2-h IOP (OR 1.23, 95% CI 1.02\u20131.47) and postoperative 2-h IOP &amp;lt;20\u2009mmHg (OR 25.1, 95% CI 1.05\u2013602) increased the risk of graft detachment. Lower postoperative 2-h IOP, particularly below 20\u2009mmHg, may increase the risk of graft detachment, and diabetes in recipients may pose a higher risk of graft detachment after DMEK.<\/jats:p>","DOI":"10.3389\/fmed.2024.1266049","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T04:44:56Z","timestamp":1707367496000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for early graft detachment requiring rebubbling in Descemet membrane endothelial keratoplasty with imported pre-cut donor tissues"],"prefix":"10.3389","volume":"11","author":[{"given":"Chung Young","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Ho","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mee Kum","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/01.ico.0000248385.16896.34","article-title":"Descemet membrane endothelial keratoplasty (DMEK)","volume":"26","author":"Melles","year":"2006","journal-title":"Cornea"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ajo.2018.01.018","article-title":"Trends in corneal transplantation from 2001 to 2016 in Germany: a report of the DOG-section cornea and its Keratoplasty registry","volume":"188","author":"Flockerzi","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.ophtha.2014.09.004","article-title":"Clinical outcome of 500 consecutive cases undergoing Descemet's membrane endothelial keratoplasty","volume":"122","author":"Rodr\u00edguez-Calvo-de-Mora","year":"2015","journal-title":"Ophthalmology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1016\/j.ophtha.2015.07.003","article-title":"The first 100 eyes of standardized Descemet stripping automated endothelial Keratoplasty versus standardized Descemet membrane endothelial Keratoplasty","volume":"122","author":"Hamzaoglu","year":"2015","journal-title":"Ophthalmology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.ophtha.2017.08.015","article-title":"Descemet membrane endothelial Keratoplasty: safety and outcomes: a report by the American Academy of ophthalmology","volume":"125","author":"Deng","year":"2018","journal-title":"Ophthalmology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/ico.0000000000001646","article-title":"Preloaded Descemet membrane endothelial Keratoplasty donor tissue: surgical technique and early clinical results","volume":"37","author":"Newman","year":"2018","journal-title":"Cornea"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1097\/ico.0000000000000479","article-title":"Standardized DMEK technique: reducing complications using Prestripped tissue, novel glass injector, and sulfur hexafluoride (SF6) gas","volume":"34","author":"Terry","year":"2015","journal-title":"Cornea"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1016\/j.ophtha.2015.05.013","article-title":"Comparison of sulfur hexafluoride 20% versus air tamponade in Descemet membrane endothelial Keratoplasty","volume":"122","author":"G\u00fcell","year":"2015","journal-title":"Ophthalmology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1136\/bjophthalmol-2016-309653","article-title":"One-year outcome after Descemet membrane endothelial keratoplasty (DMEK) comparing sulfur hexafluoride (SF(6)) 20% versus 100% air for anterior chamber tamponade","volume":"101","author":"Schaub","year":"2017","journal-title":"Br J Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.ajo.2016.08.005","article-title":"Impact of donor age on Descemet membrane endothelial Keratoplasty outcome: evaluation of donors aged 17-55 years","volume":"170","author":"Schaub","year":"2016","journal-title":"Am J Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1001\/jamaophthalmol.2013.6222","article-title":"Graft adhesion in descemet membrane endothelial keratoplasty dependent on size of removal of host's descemet membrane","volume":"132","author":"Tourtas","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/ico.0000000000001055","article-title":"Role of initial intraocular pressure in graft adhesion after Descemet membrane endothelial Keratoplasty","volume":"36","author":"Schmeckenb\u00e4cher","year":"2017","journal-title":"Cornea"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1001\/jamaophthalmol.2015.4499","article-title":"Association between graft storage time and donor age with endothelial cell density and graft adherence after Descemet membrane endothelial Keratoplasty","volume":"134","author":"Rodr\u00edguez-Calvo de Mora","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.2147\/opth.S147217","article-title":"Influences on rebubble rate in Descemet's membrane endothelial keratoplasty","volume":"11","author":"Mechels","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.ajo.2017.12.014","article-title":"Factors associated with early graft detachment in primary Descemet membrane endothelial Keratoplasty","volume":"187","author":"Leon","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1097\/ico.0000000000000740","article-title":"Rate and localization of graft detachment in Descemet membrane endothelial Keratoplasty","volume":"35","author":"Maier","year":"2016","journal-title":"Cornea"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.ophtha.2013.09.032","article-title":"Descemet's membrane endothelial keratoplasty: clinical results of single versus triple procedures (combined with cataract surgery)","volume":"121","author":"Chaurasia","year":"2014","journal-title":"Ophthalmology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1136\/bjophthalmol-2020-316478","article-title":"The Cologne rebubbling study: a reappraisal of 624 rebubblings after Descemet membrane endothelial keratoplasty","volume":"105","author":"Siebelmann","year":"2021","journal-title":"Br J Ophthalmol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e0270037","DOI":"10.1371\/journal.pone.0270037","article-title":"Clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) with imported donor corneas in eyes of Asian patients; endothelium-in versus endothelium-out method","volume":"17","author":"Jung","year":"2022","journal-title":"PLoS One"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1097\/icu.0000000000000060","article-title":"Eye-bank preparation of endothelial tissue","volume":"25","author":"Boynton","year":"2014","journal-title":"Curr Opin Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1007\/s00417-015-3103-2","article-title":"Causes that influence the detachment rate after Descemet membrane endothelial keratoplasty","volume":"253","author":"R\u00f6ck","year":"2015","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref22","volume-title":"Fundamental Research Statistics for the Behavioral Sciences","author":"Roscoe","year":"1975"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.ajo.2017.03.021","article-title":"Rebubbling in Descemet membrane endothelial Keratoplasty: influence of pressure and duration of the Intracameral air tamponade","volume":"178","author":"Pilger","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1097\/ico.0000000000001677","article-title":"Influence of postoperative intraocular pressure on graft detachment after Descemet membrane endothelial Keratoplasty","volume":"37","author":"Heinzelmann","year":"2018","journal-title":"Cornea"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1097\/ico.0000000000001305","article-title":"Effect of donor and recipient diabetes status on Descemet membrane endothelial Keratoplasty adherence and survival","volume":"36","author":"Price","year":"2017","journal-title":"Cornea"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.exer.2016.10.015","article-title":"Descemet membrane adhesion strength is greater in diabetics with advanced disease compared to healthy donor corneas","volume":"153","author":"Schwarz","year":"2016","journal-title":"Exp Eye Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1016\/j.ophtha.2011.03.025","article-title":"Characterization of the cleavage plane in DESCemet's membrane endothelial keratoplasty","volume":"118","author":"Schl\u00f6tzer-Schrehardt","year":"2011","journal-title":"Ophthalmology"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/ICO.0000000000003118","article-title":"Rate of endothelial cell loss and graft survival in Descemet membrane endothelial Keratoplasty in eyes requiring a Rebubble","volume":"42","author":"Tapley","year":"2023","journal-title":"Cornea"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1266049\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T04:44:58Z","timestamp":1707367498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1266049\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,8]]},"references-count":28,"alternative-id":["10.3389\/fmed.2024.1266049"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1266049","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,8]]},"article-number":"1266049"}}