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Postmortem evaluation of wound healing after Descemet's membrane endothelial keratoplasty (DMEK)

Poster Details

First Author: T.Müller THE NETHERLANDS

Co Author(s):    I. Lavy   R. Verdijk   M. Bruinsma   J. Parker   P. Binder   G. Melles     

Abstract Details


To describe the histologic features of postmortem eyes after Descemet membrane endothelial keratoplasty (DMEK) and their potential clinical implications.


Netherlands Institute of Innovative Ocular Surgery


Eleven postmortem corneas of eight patients, who underwent DMEK surgery for Fuchs endothelial dystrophy with an average postoperative time of 4 �Â�± 1.9 years were procured after death and processed for light microscopy evaluation.


Nine eyes showed a �â�€�˜normal�â�€�™ anatomy in the corneal center. One eye had an anatomically 'normal' periphery, ten showed peripheral abnormalities: in nine, the DMEK-graft overlapped with the host edge of the descemetorhexis; one eye showed a acellular scarring overlying a portion of the DMEK-graft that was detached followed by spontaneously adherence; three eyes showed graft folds with scar-tissue anteriorly; in two eyes (same patient), the anterior banded layer of the host DM was still in-situ across the cornea (both required re-bubbling); and two eyes showed host DM-remnants within the corneo-limbal tunnel incision that may have interfered with wound healing.


Incomplete host DM removal may relate to postoperative DMEK graft detachment and wound instability. Graft detachments may re-attach with interface scarring. Re-bubbling procedures may be performed within 4-6 weeks, before scarring of detached graft portions occurs.

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