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Desemet's membrane endothelial keratoplasty (DMEK): learning curve in the first 50 cases

Poster Details

First Author: J.Ashar INDIA

Co Author(s):                        

Abstract Details


To describe the learning curve of first consecutive 50 DMEK done by a single surgeon


Mumbai Eye Care


Retrospective analysis of cases with undergoing DMEK with at least 1 month of follow up were included in the study. 50 eyes of 42 patients underwent DMEK for PBK (22), Fuchs Dystrophy (24), ICE syndrome (1), Failed graft (1), TASS (1), Post glaucoma (1). 14 cases of Fuchs- combined with phacoemulsification. using standard no touch technique. The donor tissue was harvested using Scuba method in all cases. Difficulties during each step of the surgery during the learning curve were analyzed. Postoperative outcomes were analyzed in terms of graft clarity, vision, time to achieve cornea clarity and complications.50 eyes underwent DMEK


The intraoperative complications- radial donor DM tear extending in the center while DM stripping (3 cases), graft jetting out of eye during insertion (2 cases-1 from main port /1 from side port), difficult unrolling (6 cases). Post operative complications included graft detachment -2, pupillary block 3, primary graft failure (3- DSEK done for 2/ PK for 1), malignant glaucoma (1). Secondary graft failure after 3 months was seen in 3 cases (PK done for 2/ DSEK for 1). Visual acuity improved median from less than 6/60 to median 6/12p at 3 months. 18 cases had 6/9, 10 between 6/18- 6/9p


DMEK has a steep learning curve. With practice intraoperative complications can be decreased. The visual outcomes are good and faster clearing of the cornea is seen with DMEK.

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