{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:19:37Z","timestamp":1783567177971,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>Objectives: To analyze the outcomes and complications of Descemet\u2018s membrane endothelial keratoplasty (DMEK) performed without prophylactic peripheral iridotomy (PI). Methods: Design: Retrospective study. Setting: Institutional, tertiary care eye hospital. Study Population: All patients who underwent DMEK or DMEK combined with phacoemulsification (DMEK triple) for Fuchs endothelial dystrophy, using a standardized protocol between August 2016 and July 2021, were included. Previous glaucoma surgery, laser PI, aphakia, or complicated pseudophakia were excluded. Main outcome measures: Primary outcomes: Incidence of pupillary block (PB). Secondary outcomes: Graft detachment (GD), rebubbling rates, uncorrected (UCDVA) and best corrected logMAR distance visual acuity (BCDVA), and endothelial cell loss (ECL) at six months. Data were analyzed using the chi-square test and stepwise backward regression analysis. Results: 104 eyes of 72 patients were included. Four eyes (3.8%) developed PB; in two of these cases, standard protocol was not followed. Overall minor GD occurred in 43.2% (n = 45); significant GD was present only in 7 eyes (6.6%). Overall slit lamp rebubbling rate was 30% (n = 35), though only four patients were rebubbled in theatre (3.8%). PB, GD, and rebubbling rates did not vary with the surgeon, surgery, or tamponade (air or SF6 gas). UCDVA, BCDVA, and ECL at 6 months were 0.29 \u00b1 0.31, 0.20 \u00b1 0.28, and 40.46 \u00b1 20.36%, respectively. Conclusions: Compared to previously reported outcomes of DMEK with PI, our results of PI less DMEK using a standardized protocol have a similar incidence of pupillary block, graft detachment, and rebubbling, with comparable visual acuity and endothelial cell loss.<\/jats:p>","DOI":"10.3390\/vision7020041","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T10:08:55Z","timestamp":1684490935000},"page":"41","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical Outcomes of Descemet\u2019s Membrane Endothelial Keratoplasty without Routine Prophylactic Peripheral Iridotomy"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-6461","authenticated-orcid":false,"given":"Ritika","family":"Mukhija","sequence":"first","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN11 2DH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Quiney","sequence":"additional","affiliation":[{"name":"Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0667-3700","authenticated-orcid":false,"given":"Mayank A.","family":"Nanavaty","sequence":"additional","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN11 2DH, UK"},{"name":"Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/s00417-015-3248-z","article-title":"Outcomes of Descemet membrane endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and penetrating keratoplasty from a single centre study","volume":"254","author":"Heinzelmann","year":"2016","journal-title":"Graefes Arch. 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