Original articlePreliminary Clinical Results of Descemet Membrane Endothelial Keratoplasty
Section snippets
Methods
The DMEK was performed in four male and six female patients, 45 to 87 years of age, with Fuchs endothelial dystrophy (Table).
Results
In three eyes the implantation of the donor DM was traumatic attributable to complicated donor tissue insertion, vitreous pressure, and incomplete unfolding of the tissue (Cases 2, 4, and 10, respectively; Table). In Case 2, the graft was inadvertently positioned halfway within the tunnel incision, due to reflux of fluid from the anterior chamber immediately after the injection of the tissue. In Case 4, the anterior chamber showed a strong tendency to collapse throughout the procedure. Although
Discussion
In 1998, we reported that transplantation of DM was technically feasible in a human cadaver eye model.11, 12 At that time however, harvesting DM from a donor corneo-scleral rim was considered too challenging in the absence of supporting eyebank facilities. Because stripping DM may sometimes be complicated by inadvertent tearing of the membrane, the surgical preparation of a donor DM sheet may preferably be performed in an eyebank prior to the surgery rather than as a part of the surgical
Gerrit R. J. Melles, MD, PhD, attended medical school and interned at the University of Leyden, The Netherlands, and did his Ophthalmology residency at the University of Nijmegen, The Netherlands. He completed a Research fellowship in San Diego with Perry S. Binder, MD, who also supervised his PhD dissertation. Dr Melles is currently director of the Netherlands Institute of Innovative Ocular Surgery (www.niios.com), and head of Amnitrans Eyebank, in Rotterdam, The Netherlands.
References (25)
- et al.
Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy
Am J Ophthalmol
(1999) - et al.
Descemet’s stripping with endothelial keratoplasty in 200 eyesEarly challenges and techniques to enhance donor adherence
J Cataract Refract Surg
(2006) - et al.
Endothelial cell density after posterior lamellar keratoplasty (Melles technique): three years follow-up
Am J Ophthalmol
(2004) - et al.
Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)
Am J Ophthalmol
(2004) - et al.
Corneal changes after cataract surgery with 5.0 mm sutured and 3.5 mm sutureless clear corneal incisions
J Cataract Refract Surg
(1997) - et al.
Corneal versus scleral tunnel incision in cataract surgery: a randomized study
J Cataract Refract Surg
(1997) - et al.
Corneal endothelial cell transplantation using Descemet’s membrane as a carrier
J Cataract Refract Surg
(1993) - et al.
A technique to harvest Descemet’s membrane with viable endothelial cells for selective transplantation
Am J Ophthalmol
(2005) - et al.
A surgical technique for posterior lamellar keratoplasty
Cornea
(1998) - et al.
Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision
Ophthalmology
(2000)
Deep lamellar endothelial keratoplasty in the first United States patients: early clinical results
Cornea
Sutureless, posterior lamellar keratoplasty
Cornea
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Gerrit R. J. Melles, MD, PhD, attended medical school and interned at the University of Leyden, The Netherlands, and did his Ophthalmology residency at the University of Nijmegen, The Netherlands. He completed a Research fellowship in San Diego with Perry S. Binder, MD, who also supervised his PhD dissertation. Dr Melles is currently director of the Netherlands Institute of Innovative Ocular Surgery (www.niios.com), and head of Amnitrans Eyebank, in Rotterdam, The Netherlands.