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Chapter-085 Descemet's Membrane Endothelial Keratoplasty (DMEK)

BOOK TITLE: Copeland and Afshari's Principles and Practice of Cornea (2 Volumes)

Author
1. Melles Gerrit RJ
2. Dapena Isabel
3. Liarakos Vasilios S
4. Dirisamer Martin
5. Naveiras Miguel
6. Yeh Ru-Yin
7. Quilendrino Ruth
8. Droutsas Konstantinos
9. Moutsouris Kyros
10. Bruinsma Marieke
ISBN
9789350901724
DOI
10.5005/jp/books/11777_85
Edition
1/e
Publishing Year
2013
Pages
16
Author Affiliations
1. Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands, Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
2. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
3. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
4. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
5. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
6. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
7. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
8. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
9. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
10. Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands
Chapter keywords
Endothelial keratoplasty, DMEK, Descemet’s membrane, DMEK graft, Descemetorhexis

Abstract

DMEK is one of the EK techniques described for the transplantation of healthy donor corneal endothelium. DMEK may be performed by the average corneal surgeon in any clinical setting and with relatively low costs. Providing the best clinical outcomes among the currently available endothelial keratoplasty (EK) techniques, DMEK may have potential to become the first treatment option for endothelial disorders. The chapter describes the surgical procedures of DMEK technique. The steps explained include: preoperative preparation of the DMEK graft, DMEK technique (obtaining a soft eye, incisions and descemetorhexis, intraoperative preparation of the DMEK graft, implantation, orientating, unfolding, centering, appositioning, and fixating), visual rehabilitation rate and refractive outcome, endothelial cell density and graft survival, and complications (graft detachment, secondary glaucoma, and allograft rejection).

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