{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:40Z","timestamp":1760144020486,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebubbling (ARB). Methods: Retrospectively, we investigated predictive factors related to GD between January 2016 and March 2020, a pre-COVID era, in 72 patients, 72 eyes, and their donors\u2019 lamellar characteristics, focusing on donor\u2019s cause of death. The patients were divided according to the posterior lamellar keratoplasty technique adopted. Results: GD and consequent ARB were most common but not significantly prevalent in DMEK (p = 0.11). It was more common in FED for both surgical approaches. Only in BK treated with DSAEK were host steeper mean astigmatism (p = 0.03) and donors with smaller graft pre-cut diameters (p = 0.02) less likely to be related to GD. Regarding donor\u2019s cause of death, only cardiovascular accident could be related to GD in BK treated with DMEK (p = 0.04). Conclusions: Our study shows that the conventional match between pathology and corneal lenticule is not sufficient to prevent ARB. Donor\u2019s cause of death can impair graft and host attachment. In particular, cardiovascular death may impair the efficiency of donors\u2019 endothelial cells, inducing GD after DMEK in BK.<\/jats:p>","DOI":"10.3390\/jcm13061593","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T04:51:12Z","timestamp":1710132672000},"page":"1593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Donor Characteristics in Graft Detachment after Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy and Bullous Keratopathy"],"prefix":"10.3390","volume":"13","author":[{"given":"Nicola","family":"Cardascia","sequence":"first","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8029-6953","authenticated-orcid":false,"given":"Flavio","family":"Cassano","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"},{"name":"UOC Oftalmologia, Ospedale Vito Fazzi, 73100 Lecce, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Pastore","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Gabriella","family":"La Tegola","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-0434","authenticated-orcid":false,"given":"Alessandra","family":"Sborgia","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Boscia","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Alessio","sequence":"additional","affiliation":[{"name":"UOC Oftalmologia Universitaria, Ospedale Universitario Consorziale Policlinico Giovanni XXIII di Bari, Universit\u00e0 degli Studi di Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ICL.0000000000000469","article-title":"Fuchs Endothelial Corneal Dystrophy: Update on Pathogenesis and Future Directions","volume":"45","author":"Sarnicola","year":"2019","journal-title":"Eye Contact Lens"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1146\/annurev-vision-091718-014852","article-title":"Fuchs Endothelial Corneal Dystrophy: Clinical, Genetic, Pathophysiologic, and Therapeutic Aspects","volume":"5","author":"Matthaei","year":"2019","journal-title":"Annu. Rev. Vis. Sci."},{"key":"ref_3","first-page":"CD008420","article-title":"Endothelial keratoplasty versus penetrating keratoplasty for Fuchs endothelial dystrophy","volume":"2","author":"Nanavaty","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1590\/S0004-27492008000700012","article-title":"Ceratopatia bolhosa: Etiopatog\u00eanese e tratamento [Bullous keratopathy: Etiopathogenesis and treatment]","volume":"71","author":"Campos","year":"2008","journal-title":"Arq. Bras. Oftalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.22336\/rjo.2017.17","article-title":"Pseudophakic bullous keratopathy","volume":"61","author":"Pricopie","year":"2017","journal-title":"Rom. J. Ophthalmol."},{"key":"ref_6","unstructured":"Gurnani, B., and Kaur, K. (2023, August 28). Pseudophakic Bullous Keratopathy, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK574505."},{"key":"ref_7","first-page":"15","article-title":"Graft Detachment After Descemet\u2019s Stripping Automated Endothelial Keratoplasty in Bullous Keratopathy and Fuchs Dystrophy","volume":"9","author":"Cardascia","year":"2020","journal-title":"Med. Hypothesis Discov. Innov. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/APO.0000000000000265","article-title":"The Rapid Transformation of Transplantation for Corneal Endothelial Diseases: An Evolution From Penetrating to Lamellar to Cellular Transplants","volume":"8","author":"Zhang","year":"2019","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/bjophthalmol-2016-309021","article-title":"New Zealand trends in corneal transplantation over the 25 years 1991\u20132015","volume":"101","author":"Kim","year":"2017","journal-title":"Br. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1001\/jamaophthalmol.2015.4776","article-title":"Global survey of corneal transplantation and eye banking","volume":"134","author":"Gain","year":"2016","journal-title":"JAMA Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.ajo.2019.06.012","article-title":"Descemet Membrane Endothelial Keratoplasty versus Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty","volume":"207","author":"Woo","year":"2019","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/ICO.0000000000002861","article-title":"Evaluation of Efficacy, Efficiency, and Cell Viability of a Novel Descemet Membrane Endothelial Keratoplasty Graft Preparation Device, DescePrep, in Nondiabetic and Diabetic Human Donor Corneas","volume":"41","author":"Solley","year":"2021","journal-title":"Cornea"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1097\/ICO.0000000000002398","article-title":"Donor DMEK Tissue Characteristics: Association with Rebubble Rate and 6-Month Endothelial Cell Loss","volume":"39","author":"Straiko","year":"2020","journal-title":"Cornea"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1097\/ICO.0000000000002582","article-title":"Younger Donor Tissue in Descemet Membrane Endothelial Keratoplasty Surgery: Clinical Outcomes","volume":"40","author":"Hill","year":"2021","journal-title":"Cornea"},{"key":"ref_15","doi-asserted-by":"crossref","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\u201355 Years","volume":"170","author":"Schaub","year":"2016","journal-title":"Am. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/aos.14994","article-title":"Influence of time to procurement, incubation and release of organ cultured donor corneas on graft failure after Descemet Stripping Automated Endothelial Keratoplasty","volume":"100","author":"Gram","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"00469580211045846","DOI":"10.1177\/00469580211045846","article-title":"Does Storage Time Affect the Outcomes of Split Corneal Transplantation to Reduce Corneal Donor Shortage? A Retrospective study","volume":"58","author":"Kandemir","year":"2021","journal-title":"Inquiry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/bjophthalmol-2020-317608","article-title":"Eye bank versus surgeon prepared DMEK tissues: Influence on adhesion and re-bubbling rate","volume":"106","author":"Romano","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1080\/02713683.2018.1431286","article-title":"Impact of 10% SF6 Gas Compared to 100% Air Tamponade in Descemet\u2019s Membrane Endothelial Keratoplasty","volume":"43","author":"Rickmann","year":"2018","journal-title":"Curr. Eye Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1442-9071.2010.02213.x","article-title":"Endothelial keratoplasty\u2014A review","volume":"38","author":"Price","year":"2010","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1016\/j.ophtha.2009.06.021","article-title":"Descemet\u2019s stripping endothelial keratoplasty: Safety and outcomes: A report by the American Academy of Ophthalmology","volume":"116","author":"Lee","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/1120672118757431","article-title":"DMEK versus DSAEK for Fuchs\u2019 endothelial dystrophy: A meta-analysis","volume":"29","author":"Marques","year":"2019","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_23","first-page":"831051","article-title":"Influence of Donor Tissue Factors on Detachment Rate in DSAEK Patients","volume":"25","author":"Demsey","year":"2011","journal-title":"ISRN Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.ophtha.2009.09.054","article-title":"Graft detachment rate","volume":"117","author":"Dapena","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.sjopt.2011.05.006","article-title":"Histopathological findings of failed grafts following Descemet\u2019s stripping automated endothelial keratoplasty (DSAEK)","volume":"26","author":"Alkatan","year":"2012","journal-title":"Saudi J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/jovr.jovr_55_17","article-title":"Effect of Donor Graft Thickness on Clinical Outcomes after Descemet Stripping Automated Endothelial Keratoplasty","volume":"14","author":"Feizi","year":"2019","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/ICO.0b013e3181eae8ff","article-title":"Late-onset deep infectious keratitis after descemet stripping endothelial keratoplasty with vent incisions","volume":"30","author":"Hannush","year":"2011","journal-title":"Cornea"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.2147\/OPTH.S23867","article-title":"In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions","volume":"5","author":"Moshirfar","year":"2011","journal-title":"Clin. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.joco.2017.11.009","article-title":"Effect of venting incisions on graft attachment in Descemet\u2019s stripping automated endothelial keratoplasty","volume":"30","author":"Mohebbi","year":"2017","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.jfo.2009.05.004","article-title":"Complications apr\u00e8s Descemet stripping automated endothelial keratoplasty: \u00c9tude monocentrique sur 32 yeux [Survey of complications in Descemet stripping automated endothelial keratoplasty in 32 eyes]","volume":"32","author":"Ponchel","year":"2009","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1016\/j.ophtha.2008.01.024","article-title":"Complications of Descemet\u2019s stripping with automated endothelial keratoplasty: Survey of 118 eyes at One Institute","volume":"115","author":"Suh","year":"2008","journal-title":"Ophthalmology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/6\/1593\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:11:43Z","timestamp":1760105503000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/6\/1593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,11]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13061593"],"URL":"https:\/\/doi.org\/10.3390\/jcm13061593","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,3,11]]}}}