Impact of 10% SF6 Gas Compared to 100% Air Tamponade in Descemet's Membrane Endothelial Keratoplasty

• Published in: Current eye research Vol. 43; no. 4; pp. 482 - 486
• Main Authors: Rickmann, Annekatrin, Szurman, Peter, Jung, Sacha, Boden, Karl Thomas, Wahl, Silke, Haus, Arno, Boden, Katrin, Januschowski, Kai
• Format: Journal Article
• Language: English
• Published: Taylor & Francis 03-04-2018
• Subjects: anterior chamber tamponade; DMEK; re-bubbling; sulfur hexafluoride
• ISSN: 0271-3683; 1460-2202
• DOI: 10.1080/02713683.2018.1431286

Purpose: To compare the clinical outcomes following Descemet's membrane endothelial keratoplasty (DMEK) with 100% air tamponade versus 10% sulfur hexafluoride (SF
6
) tamponade.
Methods: Retrospective analysis of 108 consecutive DMEK cases subdivided by anterior chamber tamponade with 54 eyes receiving 10% SF
6
and 54 eyes receiving 100% air injection. A post-hoc matched analysis revealed no statistically significant differences between the groups. The main outcome measurements were the complication rate, including intra- and postoperative complications and graft detachment rate requiring re-bubbling. Clinical outcome included best-corrected visual acuity (BCVA), endothelial cell count (ECC), and central corneal thickness (CCT) measured 1, 3, and 6 months after DMEK surgery.
Results: The graft detachment rate with consecutive re-bubbling was 18.5% in the air group and 22.2% in the SF
6
group (p = 0.2). Remaining small peripheral graft detachments with a clear cornea occurred more often in the 100% air group (air: 22.2%; 12/54, 6/12 inferior compared to SF
6
: 7.4%; 4/54, 2/4 inferior; p = 0.06). The primary graft failure rate was comparable between the two groups. No complete graft detachment occurred. Outcome results for BCVA, ECC, and CCT at all follow-up time points were comparable between the two groups.
Conclusion: The clinical outcomes (including re-bubbling rate, primary graft failure rate, and endothelial cell loss) were comparable with 100% air versus 10% SF
6
tamponade, whereas other studies suggest that a higher SF
6
concentration (20%) may result in a lower re-bubbling rate.