Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S)

Studený, Pavel; Farkas, Andrej; Vokrojova, Magdalena; Lišková, Petra; Jirsová, Kateřina

doi:10.1136/bjo.2009.165134

Cited by 87 publications

(69 citation statements)

References 26 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4] Recently, we further refined the concept of endothelial keratoplasty by introducing selective transplantation of Descemet membrane (DM) and its donor endothelium, referred to as DM endothelial keratoplasty (DMEK). [5][6][7][8][9] From the introduction of deep lamellar endothelial keratoplasty, DSEK, and Descemet stripping automated endothelial keratoplasty, we learned that adaptation of a technique among peers may depend not only on the feasibility and clinical outcome but also on the incidence of complications and their possible management. With all endothelial keratoplasty techniques, graft detachment may be the most frequent complication.…”

mentioning

confidence: 99%

Prevention and Management of Graft Detachment in Descemet Membrane Endothelial Keratoplasty

Dirisamer¹

2012

Arch Ophthalmol

149

129

View full text Add to dashboard Cite

To describe the prevention and management of various types of graft detachment after Descemet membrane endothelial keratoplasty.Methods: In 150 consecutive eyes that underwent Descemet membrane endothelial keratoplasty, the incidence and type of graft detachment were studied at 1, 3, 6, 9, 12, and 24 months after surgery in a nonrandomized, prospective clinical study at a tertiary referral center. Four groups of detachments were identified: a partial detachment of one-third or less of the graft surface area (n=16; group 1); a partial detachment of more than one-third of the graft surface area (n=8; group 2); a graft positioned upside down (n = 4; group 3); and a free-floating Descemet roll in the host anterior chamber (n=8; group 4).Results: Partial or complete graft detachment was found in 36 cases (24%), of which 18 (12%) were clinically significant. All 24 eyes with a partial detachment (groups 1 and 2) showed spontaneous corneal clearance, and all but 6 of these eyes (75%) reached visual acuity of 20/40 or better (Ն0.5). A reversed clearance pattern and interface spikes were observed in eyes with the graft positioned upside down (group 3). Eyes with a free-floating graft (group 4) showed persistent corneal edema. Detachments were associated with inward folds (12 eyes [33%]), insufficient airbubble support (7 eyes [19%]), upside-down graft positioning (4 eyes [11%]), use of plastic materials (2 eyes [6%]), irido-graft synechiae (1 eye [3%]), poor endothelial morphology (1 eye [3%]), and stromal irregularity under the main incision (1 eye [3%]); 14 (58%) of the partial detachments were localized inferiorly.Conclusions: Awaiting spontaneous clearance may be advocated in eyes with a partial detachment. Minor adjustments in surgical protocol as well as careful patient selection may further reduce the incidence of graft detachment after Descemet membrane endothelial keratoplasty to 4% or less.

show abstract

mentioning

confidence: 99%

Prevention and Management of Graft Detachment in Descemet Membrane Endothelial Keratoplasty

Dirisamer¹

2012

Arch Ophthalmol

149

129

View full text Add to dashboard Cite

show abstract

“…22 Variations on DMEK surgery do exist, however, with DMAEK and DMEK-S being the most prominent examples. [32][33][34][35] These differ from regular DMEK in that a stromal rim is left attached to the periphery of the graft during preparation, which allows grasping and a 'drag-and-drop' insertion method. Otherwise, the surgery is the same.…”

Section: A and B: When The Dmek-graft Is Oriented Correctly Within Thmentioning

confidence: 99%

Descemet Membrane Endothelial Keratoplasty—A Review

Parker¹,

Parker²,

Melles³

2013

US Ophthalmic Review

View full text Add to dashboard Cite

Descemet membrane endothelial keratoplasty (DMEK) is the most recent step forward in the evolution of endothelial keratoplasty toward thinner grafts and more natural, anatomic corneal restoration. Offering unprecedented visual results and requiring no special or expensive equipment, DMEK has the potential to become the first line treatment for corneal endothelial disorders. The surgery's perceived shortcomings (primarily technical difficulty) have mostly been addressed by new 'no-touch' procedures for both graft preparation and graft unfolding in the recipient eye. And as a result, DMEK has been gaining traction with ophthalmologists the world over. Now, in its most recent formulation, DMEK is ready for the typical corneal surgeon, in any clinical setting, and at low cost.

show abstract

“…2 Other partial thickness procedures are deep lamellar endothelial keratoplasty, Descemet stripping endothelial keratoplasty, 3 Descemet stripping automated endothelial keratoplasty (DSAEK), 4 Descemet membrane endothelial keratoplasty (DMEK), 5 Descemet membrane automated endothelial keratoplasty, 6 and DMEK without microtome. 7 Descemet stripping automated endothelial keratoplasty is a modified technique of Descemet strip ping endothelial keratoplasty, where a microkeratome is used for the donor dissection. 8 It was first described in 2006 by Dr. Mark Gorovoy.…”

Section: Introductionmentioning

confidence: 99%

“…A modification of DMEK was described in 2009 where a rim of stroma was left at the periphery of the donor tissue using microkeratome (Descemet membrane automated endothelial keratoplasty) and in 2010 manually without microkeratome. 7 Among all partial thickness procedures, DSAEK is the most common type of endothelial keratoplasty performed worldwide. 8 The aim of our study is to report our experience at King Hussein Medical Center with DSAEK.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Althawabi

Asfour²,

Al-Madani³

2017

Exp Clin Transplant

View full text Add to dashboard Cite

. Patients who underwent Descemet stripping automated endothelial keratoplasty were enrolled in the study. We performed a comprehensive overview of the advantages of the surgery and analyzed the donor tissue selection criteria, indications, detailed surgical techniques of the procedure, and surgical outcomes. Results: Our cohort included 13 patients. We had successful results for all of our patients, with final visual acuity of more than 6/12. The 2 indications for surgery were pseudophakic bullous keratopathy and Fuchs endothelial dystrophy. Conclusions: Descemet stripping automated endothelial keratoplasty is becoming a revolutionary procedure in corneal surgery and replacing penetrating keratoplasty in many clinical situations.

show abstract

Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S)

Abstract: Preliminary outcomes show that DMEK-S may be used in the treatment of corneal endothelial dysfunction. As this approach is entirely manual, and no special surgical equipment is needed, it has the potential to become widely adopted.

Cited by 87 publications

References 26 publications

Prevention and Management of Graft Detachment in Descemet Membrane Endothelial Keratoplasty

Prevention and Management of Graft Detachment in Descemet Membrane Endothelial Keratoplasty

Descemet Membrane Endothelial Keratoplasty—A Review

Untitled

Contact Info

Product

Resources

About