Novel Technique for the Preparation of Corneal Grafts for Descemet Membrane Endothelial Keratoplasty

Muraine, M.; Gueudry, J.; Hé, Zhiguo; Piselli, S; Lefèvre, Sabine; Toubeau, D.

doi:10.1016/j.ajo.2013.05.041

Cited by 85 publications

(45 citation statements)

References 32 publications

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“…31 This does not imply that improvements are not possible anymore. Different groups are developing and testing new techniques for all steps of the DMEK process, from new methods of donor preparation [32][33][34][35] to new intraoperative procedures including the usage of 20% sulfur hexafluoride (SF 6 ) gas, which could exert pressure on the graft for a longer time after surgery. 11 Eventually, this promising approach could reduce the amount of gas filling needed to provide adequate support for the graft during the crucial period after surgery.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chamber Air Bubble to Achieve Graft Attachment After DMEK

Ćirković

Beck

Weller

et al. 2016

Cornea

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Section: Discussionmentioning

confidence: 99%

Anterior Chamber Air Bubble to Achieve Graft Attachment After DMEK

Ćirković

Beck

Weller

et al. 2016

Cornea

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“…Many new dissection techniques have been described in the recent past with the goal of less harmful preparation while yielding a more effective time and tissue management [4][5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, a focus of recent investigations was put on Descemet's membrane (DM) dissection techniques [4][5][6][7][8][9][10]. Salvaio and colleagues reported about a novel 'SubHyS' technique for DMEK lenticule preparation [10].…”

Section: Introductionmentioning

confidence: 99%

Novel liquid bubble dissection technique for DMEK lenticule preparation

Szurman

Januschowski

Rickmann

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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“…At the same time, we are still evaluating the best technique for preparation [56] and the maximum duration of preservation, especially for DMEK specimens [57,58] .…”

Section: Donor Preparationmentioning

confidence: 99%

Descemet Membrane Endothelial Keratoplasty: Update on Endothelial Transplantation Techniques

Güell¹,

Husseiny²,

Morral³

et al. 2015

Cornea

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The cornea remains in a state of deturgescence, maintained by the endothelial cell Na+/K+ ATPase and by tight junctions between endothelial cells that limit the entrance of fluid into the stroma. By maintaining an optimum level of corneal hydration, endothelial cells preserve the ordered arrangement of collagen fibers, which is crucial for corneal transparency. Fuchs' endothelial corneal dystrophy (FECD) was initially described by Fuchs in 1910 as a combination of epithelial and stromal edema in older patients. It manifests itself as bilateral, albeit asymmetric, central corneal guttae, corneal edema, and reduced vision. The Descemet membrane thickens and develops excrescences known histopathologically as guttae. Stromal edema develops, and the corneal thickness may increase to over 1,000 μm. When the edema is severe, the corneal epithelium can detach from its basement membrane, creating painful bullae on the anterior surface of the cornea. FECD is the most common endothelial dystrophy and is usually seen beyond the fifth decade of life, although not all cases are in the elderly. Pseudophakic bullous keratopathy is a term used to describe endothelial cell loss caused by surgical manipulations in the anterior chamber (usually due to pseudophakic intraocular lens (IOL) implantation, but it may be related to any other intraocular surgical procedure, obviously including phakic IOL implantation). If the corneal endothelium is damaged during surgery (as often occurs during cataract extraction, phakic IOL implantation and other procedures), the same spectrum of symptoms as found in FECD can develop, although the histological phenotype of both diseases is different and, usually, there is no guttata in pseudophakic bullous keratopathy. Full-thickness grafts have been the standard of care for treating medically uncontrollable endothelial disease for a significant number of years worldwide. However, although the success rate is 90% in low-risk patients, it is only 30-50% in more complex, higher-risk cases, and overall, 30% of cases have a rejection episode. Moreover, regrafting has become the most common indication for corneal transplantation in the US and in some places in Europe. The more recently developed lamellar keratoplasty techniques are designed to overcome some of the problems of corneal transplantation by leaving as much of the healthy cornea in place as possible. For example, endothelial keratoplasty procedures replace only the endothelium but leave the patient's cornea's refraction as well as most of its biomechanical properties fairly intact. In this chapter, we will review the actual techniques for endothelial transplantation and Güell JL (ed): Cornea.103 provide an update on the surgical strategy (mostly for Descemet membrane endothelial keratoplasty) and its clinical results and complications.

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Novel Technique for the Preparation of Corneal Grafts for Descemet Membrane Endothelial Keratoplasty

Cited by 85 publications

References 32 publications

Anterior Chamber Air Bubble to Achieve Graft Attachment After DMEK

Anterior Chamber Air Bubble to Achieve Graft Attachment After DMEK

Novel liquid bubble dissection technique for DMEK lenticule preparation

Descemet Membrane Endothelial Keratoplasty: Update on Endothelial Transplantation Techniques

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