Misconceptions in DMEK surgery

Vasanthananthan, Keamela; Kocaba, Viridiana; Dapena, Isabel; Melles, Gerrit R.J.

doi:10.1111/aos.15037

Cited by 2 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As Vasanthananthan et al described, there could be some advantages to having a tight roll. It could be easier to acquire the double-roll shape, facilitating its unfolding and the orientation check would be more obvious if the graft was upside-down [18]. Vasquez-Perez et al described "the Spinning Technique" for unfolding tightly scrolled DMEK grafts, which involved injecting short bursts of BSS to make the scroll spin continuously in a 360-degree manner.…”

Section: Discussionmentioning

confidence: 99%

Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study

Ariño-Gutierrez,

Molero-Senosiain,

Burgos-Blasco

et al. 2023

JCM

View full text Add to dashboard Cite

Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothelial cell dystrophy who underwent DMEK with very young donors (between 20 and 30 years old) were included. The following demographic data were assessed: donor’s age, donor’s endothelial cell density (ECD), preservation time, recipient’s age and sex and unfolding surgical time. Best-corrected visual acuity (BCVA; decimal system), ECD and corneal central thickness (CCT) were assessed preoperatively and at 6-month follow-up. Results: Donors’ mean age was 23.6 ± 3.6 years (range 21 to 30) and the mean ECD was 2748.6 ± 162.6 cells/mm2. All of them underwent an uneventful DMEK as a single procedure performed by one experienced surgeon (MAG) with a mean unfolding time of 7.2 ± 4.9 min (range 4 to 15). The essential steps, including patient preparation as well as DMEK graft implantation, orientation, unrolling and centering are detailed. At 6 months, BCVA was 0.6 ± 0.2, ECD was 1945.0 ± 455.5 cells/mm2 and CCT was 497.0 ± 19.7 microns. Conclusions: We hereby present the keys to overcome tightly scrolled grafts of very young donors, which prove perfectly suitable for DMEK surgery. The graft shape tends towards a double-roll and specific maneuvers are strongly recommended.

show abstract

Section: Discussionmentioning

confidence: 99%