Posters

Managing atypical and bizarre Descemet's membrane endothelial keratoplasty (DMEK) rolls with intraoperative ocular coherence tomography (i-OCT)

Poster Details

First Author: M. Calatayud SPAIN

Co Author(s):    S. Martin   J. Puig   L. Bisbe              

Abstract Details

Purpose:

To present several cases of complicated DMEK procedure due to difficulties in handling the roll. How to approach i-OCT to improve the results.

Setting:

Cornea and Ocular Surface Unit. Vall d´Hebron Hospitals. Barcelona. Spain

Methods:

Several patients with Fuchs corneal distrophy were treated with DMEK. The procedure was uneventful until we started to unfold the roll. A persistent face down roll and a progressive corneal edema, a roll too coiled to know the orientation,a loss of the blue staining... can make the surgery fail . Under low intraocular pressure conditions we performed a maneuver consisting in fixing the graft with a cannula supported on the cornea and pushing the roll in the opposite direction with a cannula parallel to the initial one to create a fluid stream to unroll the graft.

Results:

The rolls are unfolded with the help of i-OCT and adhered to the stroma with air , controlling the orientation and the absence of folds even in adversa circumstances .

Conclusions:

i-OCT is specially useful under adverse circumstances in DMEK, it makes safe and easier the graft unfolding in special cases with a difficult roll or an important corneal edema.

Financial Disclosure:

NONE