Surgeons preferences in descemet membrane endothelial keratoplasty (DMEK)

Alnahdi, Muhannad A; Alhabdan, Nawaf Abdul Aziz; Alfarhan, Abdulrahman; Taha, Mohammed A.

doi:10.1007/s10792-022-02365-8

Cited by 2 publications

(2 citation statements)

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“…The aforementioned factors emphasise the importance of proficient DMEK surgical training. Wet labs have proven to be an effective method to cultivate surgical skills 8–11. Trainee surgeons practise the technical aspects of DMEK surgery in a controlled risk-free setting to develop confidence and improve surgical performance 12…”

Section: Introductionmentioning

confidence: 99%

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Performance outcomes from a DMEK peeling and preparation wet lab

Parekh,

Wallace,

Airaldi

et al. 2024

BMJ Open Ophth

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ObjectiveTo evaluate the Descemet membrane endothelial keratoplasty (DMEK) preparation performance of trainee surgeons in an ex vivo human donor cornea DMEK wet lab simulation setting.MethodsHuman donor corneoscleral rims unsuitable for transplantation were obtained from Moorfields Lions Eye Bank. At the wet lab, graft stripping was performed by scoring the peripheral endothelium. The trypan blue positive cells (TBPC) and cell density (cells/mm2—reticule count) were counted manually before and after stripping. The procedural time, peripheral and central tears and complete peel-off were also recorded and analysed.ResultsEight trainee surgeons attended the wet lab each attempting three DMEKs. Between the first and last attempts a significant decrease was seen in the procedural time (17.6 min vs 10.6 min (p<0.05)) and the TBPC % (12.9% vs 3.8% (p<0.05)). The percentage of tears peripherally and centrally also reduced between the first and the last trials (50% vs 13% (p=0.2226) and 38% vs 0% (p=0.1327)). A significant correlation was found between longer peeling times and higher TBPC % (p<0.001) with a 0.7% endothelial mortality increase for each additional minute required to complete the peel.ConclusionsDMEK wet labs provide a controlled risk-free learning opportunity for trainee surgeons to improve confidence and competence. Wet labs improve the success rate of DMEK graft preparation as well as flatten the learning curve. This emphasises the importance of continued support for the expansion of this valuable learning resource, promoting wider uptake of DMEK surgery.

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Section: Introductionmentioning

confidence: 99%

“…Wet labs have proven to be an effective method to cultivate surgical skills. [8][9][10][11] Trainee surgeons practise the technical aspects of DMEK surgery in a controlled risk-free setting to develop confidence and improve surgical performance. 12 Wet labs use ex vivo human donor corneoscleral rims not suitable for transplantation.…”

Section: Introductionmentioning

confidence: 99%