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Review
. 2019 Jan-Mar;9(1):18-26.
doi: 10.4103/tjo.tjo_108_18.

Step-by-step Descemet's membrane endothelial keratoplasty surgery

Shin-Yi Chen  1   2 , Mark A Terry  2   3
Affiliations
Review

Step-by-step Descemet's membrane endothelial keratoplasty surgery

Shin-Yi Chen et al. Taiwan J Ophthalmol. 2019 Jan-Mar.

Abstract

With the success of Descemet's stripping automated endothelial keratoplasty (DSAEK) technique providing better outcomes in visual prognosis and theoretically lower rejection rate than penetrating keratoplasty, DSAEK dominated the realm of endothelial keratoplasty for the past decade. However, Descemet's membrane endothelial keratoplasty (DMEK) has become more and more popular worldwide due to its even lower rejection rate, faster visual recovery, better visual outcome, and lower long-term endothelial loss. In this article, we demonstrate the techniques and nuances of DMEK surgery in detail for corneal specialists who are beginning their DMEK surgeries.

Keywords: Corneal transplantation; Descemet membrane endothelial keratoplasty; endothelial keratoplasty.

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Conflict of interest statement

The authors declare that there are no conflicts of interests of this paper.

Figures

Figure 1
Figure 1
Straiko modified Jones tube. (a) Prestripped, pretrephined, premarked, prestained, and even preloaded donor Descemet's membrane endothelial keratoplasty tissue is storaged in viewing chamber. (b) Straiko Descemet's membrane endothelial keratoplasty Jones tube inserter, which consists of modified Jones tube for Descemet's membrane endothelial keratoplasty, 14 Fr suction catheter with cutting 15 mm, and 3 cc syringe
Figure 2
Figure 2
The schematic diagram of surgical procedures. (a) The markings of wound and descemetorhexis. (b) Performing inferior peripheral iridectomy. (c) Reveals how to determine right side up of tissue. While turning of the Straiko modified Jones tube clockwise, the left fold of the double-folded tissue becomes wider if it is right side up (c middle). The right fold of the tissue becomes wider if it is upside down (c right). (d) The position of tapping to open the scroll. (e) The “compress and release” technique. (f) How to center the tissue with small bubble beneath the graft. Please see the article for the detail
See this image and copyright information in PMC

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