Novel liquid bubble dissection technique for DMEK lenticule preparation

Szurman, Peter; Januschowski, Kai; Rickmann, Annekatrin; Damm, Lara-Jil; Boden, Karl; Opitz, Natalia

doi:10.1007/s00417-016-3377-z

Cited by 41 publications

(23 citation statements)

References 16 publications

(25 reference statements)

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“…DMEK was performed on the right eye using a liquid bubble dissection technique [4] for lenticular preparation by injection of trypan blue into the sub-Descemet space via a sub-Descemet tunnel creating an enlarging liquid bubble. This bubble easily detached the Descemet membrane within a few seconds.…”

Section: Case Presentationmentioning

confidence: 99%

Favourable outcome after late reorientation of an upside-down Descemet Membrane Endothelial Keratoplasty (DMEK) graft: a case report

Mariacher

Boden

et al. 2019

BMC Ophthalmol

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Background Clinical outcome after successful reorientation of an upside-down implanted DMEK (Descemet Membrane Endothelial Keratoplasty) graft 4 weeks after initial transplantation. Case presentation A 71-year-old woman presented with Fuchs’ endothelial corneal dystrophy for DMEK. After initial DMEK the donor graft was fully attached and well centred during intracameral gas filling. When the gas bubble was fully resorbed the graft started to detach. Therefore, two intracameral gas injections were consecutively performed. During the second re-bubbling, an upside-down orientation was observed and so the graft was flipped, centred, re-attached and finally stabilized by an intracameral gas bubble. Three weeks after reorientation slit lamp examinations showed a well centred and attached graft, endothelial cells that started functioning and a patient’s visual acuity of 20/40. Visual acuity increased to a 20/32 vision in the observed eye three months later and further improved to 20/20 6 months after reorientation and stayed stable between 20/32 and 20/20 during the remaining 15 months of follow-up, with a clear and well-attached graft. Conclusion Reorientation of an upside down DMEK graft was successful even 4 weeks after initial DMEK. Visual recovery and endothelial cell count increase were stepwise noticed during the first 6 months and 15 months after reorientation, respectively. Finally a favourable outcome with 20/32 to 20/20 vision at least 6 months after graft reorientation was achieved. Therefore, restoring full graft function could last several weeks or even months following (late) reorientation of an upside-down DMEK graft.

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Section: Case Presentationmentioning

confidence: 99%

Favourable outcome after late reorientation of an upside-down Descemet Membrane Endothelial Keratoplasty (DMEK) graft: a case report

Mariacher

Boden

et al. 2019

BMC Ophthalmol

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“…We performed DMEK surgery according to our standard procedure [5] (graft donor endothelial cell count 2,258 cells/mm 2 ) (Topcon, Tokyo, Japan) using 20$ sulphur hexafluoride (SF6) tamponade under parabulbar anaesthesia. Descemetorhexis and the graft were sized 8 mm.…”

Section: Case Reportmentioning

confidence: 99%

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

Helaiwa

Januschowski

Boden

et al. 2018

Case Rep Ophthalmol

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Purpose: The aim of this article is to report an unusual case of postoperative graft loss into the vitreous cavity after Descemet membrane endothelial keratoplasty (DMEK) in a patient with an unstable iris-lens diaphragm (scleral-fixated intraocular lens [sf-IOL]) and its successful retrieval with a favourable outcome. Methods: This is a retrospective case report. Results: DMEK procedure was performed in a vitrectomized eye of an 80-year-old woman with pre-existing sf-IOL due to pseudophakic bullous keratopathy. In the setting of an inadvertently created oversized Ando iridectomy and unstable iris-lens diaphragm due to sf-IOL, repeated loss of an anterior chamber gas tamponade occurred. At the 3rd postoperative day, the patient noticed a change in visual perception, and we could detect a loss of the graft into the vitreous via B-scan ultrasound. A 23-G vitrectomy was performed promptly to recover the graft using a bimanual hand-over-hand technique. Six months after DMEK, the patient had a clear cornea without dehiscences with a central corneal thickness of 533 µm and endothelial cell count of 1,219 cells/mm². Conclusions: This case demonstrates the possibility of graft recovery from the vitreous after DMEK and subsequent corneal clearing despite unstable iris-lens diaphragm and vitrectomized eye.

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“…Outcomes and complications are described in Table 4 . [ 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 ]…”

Section: Classificationmentioning

confidence: 99%

Component corneal surgery: An update

Maharana

Sahay

Singhal

et al. 2017

Indian J Ophthalmol

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Several decades ago, penetrating keratoplasty was a challenge to corneal surgeons. Constant effort by the corneal surgeon to improve the outcomes as well as utilization of the available resources has led to a revolutionary change in the field of keratoplasty. All these efforts have led to the evolution of techniques that allow a corneal surgeon to disease-specific transplant of individual layers of corneal “so-called component corneal surgery” depending on the layer of cornea affected. This has led to an improvement in corneal graft survival as well as a better utilization of corneal tissues. This article reviews the currently available literature on component corneal surgeries and provides an update on the available techniques.

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Novel liquid bubble dissection technique for DMEK lenticule preparation

Cited by 41 publications

References 16 publications

Favourable outcome after late reorientation of an upside-down Descemet Membrane Endothelial Keratoplasty (DMEK) graft: a case report

Favourable outcome after late reorientation of an upside-down Descemet Membrane Endothelial Keratoplasty (DMEK) graft: a case report

An Unusual Case of DMEK Graft Loss into the Vitreous and Its Successful Retrieval and Survival

Component corneal surgery: An update

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