Hemi-DMEK transplantation: a novel method for increasing the pool of endothelial graft tissue

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 10:16

Venue: Boulevard B

First Author: : F.Lam UK

Co Author(s): :    L. Baydoun   M. Dirisamer   J. Lie   I. Dapena   G. Melles  

Abstract Details

Purpose:

To evaluate the clinical outcome of using a large diameter semicircular Descemet graft in Descemet membrane endothelial keratoplasty (hemi-DMEK), potentially allowing the use of a single donor cornea for two endothelial keratoplasty procedures.

Setting:

Tertiary referral centre: The Melles Corneal Clinic, NIIOS, Rotterdam, The Netherlands

Methods:

A prospective evaluation of the technical feasibility and clinical outcome of hemi-DMEK. Hemi-DMEK was performed in three eyes of three patient with Fuchs endothelial dystrophy. The main outcome measures of best corrected visual acuity (BCVA) , endothelial cell density (ECD), pachymetry, and intra- and postoperative complications were recorded up to 6 months.

Results:

BCVAs at 6 months were 20/28 (0.7), 20/40 (0.5; amblyopic eye) and 20/17 (1.2). At 1 month, ECD decreased 31-49%, and endothelial cell migration appeared to continue up to six months. Central corneal thicknesses decreased from 682-707 microns before surgery to 489-534 microns at 6 months. No intra- or postoperative complications were seen.

Conclusions:

Hemi-DMEK (using half-moon shaped grafts) proved technically feasible and may give visual outcomes similar to those in routine DMEK (full-moon shaped graft). This technique may have the potential to double the availability of donor endothelial tissue for DMEK surgery.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented