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Anterior chamber retrievable mattress sutures (ARMS) in the management of DMEK graft in aniridic patients

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Session Details

Session Title: Presented Poster Session: Cornea I

Venue: Poster Village: Pod 3

First Author: : S.Stéphan FRANCE

Co Author(s): :    D. Guindolet   E. Gabison           

Abstract Details


To report a new surgical technique for graft positioning during descemet’s membrane endothelial keratoplasty (DMEK) in a patient with irian stromal atrophy using intracamerular “in-and–out” retrievable sutures : Anterior chamber Retrievable Mattress Sutures (ARMS).


Department of Ophtalmology, Fondation ophtalmologique A. de Rothschild, 25 rue Manin , 75019 Paris


A 54-year-old woman with unilateral iridocorneal endothelial syndrome and well-controlled intra-ocular pressure, presented a corneal edema. DMEK combined with phakoemulsification were performed using peroperative optic coherence tomography(OCT). To manage iris atrophy which is associated with a high risk of peroperative graft dislodgment, three temporary crossed sutures were placed into the anterior chamber, resulting in a new iris plan to maintain graft position against the cornea and to avoid graft displacement into the posterior chamber. Before intracamerular air bubble injection, ARMS were lifted allowing a better management of the air bubble positionning. The sutures were retrieved at the end.


Mean corrected visual acuity was counting fingers preoperatively and 9/10e one month after surgery. Pachymetry was 562 micrometers at 1 months.


The use of ARMS during DMEK creates a temporary iris-plane in patients presenting iris stromal atrophy. This technique could thus be a problem solving tool to facilitate optimal graft position in the absence of normal iris-plane.

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