Intraocular Graft Unfolding Techniques in Descemet Membrane Endothelial Keratoplasty

Comparison of Sulfur Hexafluoride 20% versus Air Tamponade in Descemet Membrane Endothelial Keratoplasty

“…In our opinion, tamponade with 20% SF 6 and head positioning during the first few days after surgery as well as proper centration and regular aposition of the EDM graft over the host stroma, especially using our bimanual technique (with or without an anterior air bubble), are key to prevent graft detachment. 16,18,22 The longer persistence of 20% SF 6 in the eye (2.8 days for 20% SF 6 vs. 1.6 days for 100% air) 23 and the described head positioning ensure tamponade effect in all areas of the EDM graft during the critical period of highest risk of detachment: the first 48 to 96 hours. This tamponade effect persists even at normalto-low IOP and when the gas only partially occupies the anterior chamber.…”

Relationship Between Tissue Unscrolling Time and Endothelial Cell Loss

“…5,6,11,12 In our own practice, we have achieved good results with various no-touch tapping techniques, some of which were introduced by Yoeruek and Dirisamer. 13,14 We refer to the surgical manipulations of DMEK tissue as the "dance moves" that comprise the "DMEK dance." Each donor tissue, and therefore each dance, can be different, with some dances requiring only one move and others demanding all of them.…”

“…Yet, it is unclear which dances are better for our dance partner, the DMEK tissue. Limited data suggest that the dance moves themselves do not bear any clear relationship to endothelial health, 14 but it is unknown whether or not the duration of the dance matters.…”

One year outcome of hemi-Descemet membrane endothelial keratoplasty

“…All surgeries proceeded according to the previously described standard DMEK techniques with a few adjustments [5,6]. To begin, three side-ports were created and the anterior chamber was filled with air.…”