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Session Title: Cornea surgical I
Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30
Paper Time: 09:12
Venue: Forum (Ground Floor)
First Author: : V.Liarakos GREECE
Co Author(s): : I. Dapena L. Ham G. Melles Dickman
To define various Descemet-graft unfolding techniques in Descemet membrane endothelial keratoplasty (DMEK).
Netherlands Institute for Innovative Ocular Surgery
In a retrospective analysis, the surgical videos of 100 consecutive DMEK cases with at least six months of follow-up were evaluated and categorized. The Descemet-graft unfolding methods were categorized into four basic techniques and three auxiliary techniques.
All DMEK surgeries could be completed using (a combination of) four Descemet-graft unfolding techniques: Technique I: standardized no-touch graft unfolding using a double-roll, Technique II: carpet-unrolling while fixating one graft-edge, Technique III: small air-bubble assisted unrolling and Technique IV: the single sliding cannula maneuver. Additional maneuvers included: turning-over the graft when oriented upside-down (flushing); manual graft centration with a cannula; and bubble-bumping to unfold peripheral inward folds. In 73% of surgeries Technique I was used, in 44% a combination of techniques, and auxiliary techniques in 62%. None of the techniques showed a correlation with the BCVA, endothelial cell density or postoperative complication rate (P>0.1).
DMEK may be further facilitated by using controlled techniques for unfolding the Descemet-graft inside the recipient anterior chamber, either as stand-alone techniques or used in various combinations.
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