ArticleAmerican journal of ophthalmology case reports2022
Anterior chamber fibrin reaction during Descemet membrane endothelial keratoplasty.
Article in American journal of ophthalmology case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 6 citations in OpenAlex.
- Acute tear-film disruption in treatment-naive acute anterior uveitis: A retrospective case-control study.Medicine · 2026Article
- Effectiveness of enoxaparin in preventing intraoperative fibrin formation during DMEK assessed in a before-and-after study.Scientific reports · 2025Article
- Intraoperative Fibrinous Reaction During Phacoemulsification With Posterior Chamber Intraocular Lens Implantation.Cureus · 2023Article
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Authors and funding
4 authors at 3 institutions in 1 country.
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Abstract
purposeTo report a series of five cases of intraoperative spontaneous anterior chamber fibrin reaction during Descemet Membrane Endothelial Keratoplasty (DMEK).
methodsWe retrospectively collected demographic data and data for ocular disease history for each patient. Donor age, preoperative graft endothelial density, surgical complications on surgery and intraoperative OCT videos, intraoperative management and outcome were assessed. The same standardized DMEK technique was used for all patients.
resultsWe report intraoperative fibrin formation in five eyes subjected to DMEK. Three pseudophakic eyes underwent single DMEK, and the other two underwent combined DMEK and cataract surgery. In one case, a fibrin filament was observed before graft insertion, with multiplication during surgery, whereas, in the other four cases, strands of fibrin from the iris appeared after graft insertion. This complication resulted in graft failure in four cases (80%). No recipient- or donor-related risk factor was identified. CONCLUSIONS AND IMPORTANCE: The anterior chamber fibrin reaction is a very uncommon complication of DMEK. The underlying pathophysiological mechanisms remain unknown, but analyses of surgical videos and intraoperative OCT suggest iris involvement. This phenomenon may be induced by chronic subclinical anterior chamber inflammation, due to a blood-aqueous barrier breakdown associated with acute iris trauma during surgery. Thus, intraoperative microtraumatism of the iris should be avoided.
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