Descemet membrane endothelial keratoplasty (DMEK) is a partial-thickness corneal transplantation procedure that involves selective transplantation of the Descemet membrane and endothelium. DMEK offers significant advantages over other keratoplasty techniques, such as faster visual rehabilitation, better final visual acuity due to minimal optical interface effects, lower risk of allograft rejection, and less long-term dependence on topical steroids. Despite all its advantages, DMEK has been found to be more challenging than other corneal transplantation techniques, and its steep learning curve appears to be an obstacle to its widespread use and adoption by corneal surgeons worldwide. DMEK surgical training laboratories (wet labs) provide a window of opportunity for surgeons to learn, prepare, manipulate, and deliver these grafts in a risk-free environment. Wet labs are a significant learning tool, especially for those institutions that have limited tissue availability in their local centers. We provide a step-by-step guide for preparing DMEK grafts using different techniques on human and nonhuman models with instructional videos. This article should eventually help the trainees and the educators understand the requirements for performing DMEK and conducting a DMEK wet lab and develop their skills and interests from a wide variety of available techniques.
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http://dx.doi.org/10.1016/j.survophthal.2023.06.008 | DOI Listing |
Purpose: To identify areas of consensus among experts on the performance of endothelial keratoplasty by using a modified Delphi approach, to help create a framework for novice surgeons to adopt these procedures.
Methods: Thirty-one international experts in endothelial keratoplasty participated. Two rounds of electronic survey were followed by a hybrid, virtual meeting.
Urrets-Zavalia syndrome (UZS) stands out as a rare yet clinically consequential complication associated with ophthalmic surgery, marked by the emergence of a fixed and dilated pupil. While it was originally described post-penetrating keratoplasty (PKP) in patients with keratoconus and its prevalence is notably higher following PKP, instances of UZS have been documented in the context of other procedures, including intraocular lens implantation, Descemet-stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty (DMEK). We report a unique case of bilateral UZS after uneventful DMEK surgeries, highlighting a rare but potential complication after DMEK.
View Article and Find Full Text PDFCornea
December 2024
Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar, Germany.
Purpose: The postoperative occurrence of corneal guttae (CG) in patients after Descemet membrane endothelial keratoplasty (DMEK) can lead to a significant reduction in visual acuity (VA) with the subsequent need for repeat DMEK. Therefore, the aim of this study was to analyze the prevalence and clinical significance of CG in transplanted corneas after DMEK.
Methods: The prevalence and progression of CG after DMEK of 1657 patients were examined using endothelial specular microscopy images.
Klin Monbl Augenheilkd
December 2024
Glaucoma drainage devices (GDD) are used for patients with secondary glaucoma, such as uveitic or neovascular glaucoma, which is uncontrolled under local therapy. They are also used in patients with conjunctival scarring, for example after a previous vitrectomy or after unsuccessful previous glaucoma surgery, such as trabeculectomy. They are also a treatment option for congenital glaucoma, aphakic glaucoma or for the treatment of iridocorneoendothelial syndromes.
View Article and Find Full Text PDFIntroduction: To provide an insight into the current perspective of UK ophthalmic surgeons on the role of Descemetorhexis without endothelial keratoplasty (DWEK) for the management of Fuchs endothelial corneal dystrophy (FECD).
Materials And Methods: A Google Form (Google, UK) was electronically distributed to UK ophthalmologists with a special interest in cornea from November 2023 to June 2024. The survey consisted of 13 mandatory questions.
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