Newly Modified Descemetopexy Method in Descemet’s Membrane Detachment and Prognostic Analysis: A Systematic Review

Abstract BackgroundTo present a newly modified descemetopexy method and investigate the most determinative factor in the prognosis of Descemet’s membrane detachment (DMD). MethodsThis was a retrospective review of 37 patients (38 eyes) treated with the newly modified descemetopexy method. This surgical method was combined with the vacuum technique to pump supra-Descemet’s fluid. After reviewing and screening, we enrolled 31 patients (32eyes). We evaluated outcomes using the anatomical reattachment of DM [anatomical success (AS)] and the resolution of corneal oedema [functional success (FS)]. Donor characteristics, including sex, age, the presence of diabetes, ocular history, DMD duration, DMD grade, were analysed. Patients were divided into two groups according to whether FS was achieved. Univariate and multi-factor logistic regression analyses were adopted to evaluate factors contributing to the prognosis of DMD. ResultsAS was achieved in 31 eyes (96.9%), and FS was achieved in 21 eyes (65.6%). The univariate analysis showed that both the DMD grade (P=0.029) and DMD duration (P=0.004) affect the prognosis of DMD. The multiple logistic regression analysis indicated that the DMD duration was the dominant factor (P=0.006). No significant difference was found in the DMD grade, sex, age, presence of diabetes, presence of glaucoma or DMD-originating surgery between the two groups.ConclusionsDescemetopexy combined with the vacuum technique can be used to deal with DMD. The DMD duration is the dominant factor affecting the activity of endothelial cells and the final prognosis.