Wet Lab Training To Increase Safety And Enhance Uptake Of Descement Membrane Endothelial Keratoplasty Surgery

To assess the efficacy of Descemet Membrane Endothelial Keratoplasty (DMEK) wetlab training in enhancing the proficiency and safety of DMEK surgeries, with the aim of fostering widespread adoption within the NHS UK, thereby enhancing patient outcome and broadening access to advanced keratoplasty procedures. 

Royal College of Ophthalmology venue with wetlab setting. 

Donor corneoscleral rims, deemed unsuitable for transplantation, were procured from NHSBT eye bank. Novice and experienced Surgeons (n=9) participated in the wetlab. Surveys were completed prior to and following their attendance at the wetlab course to gauge subjective impressions and ascertain any perceived improvements. During wetlab, three tissues were provided to each Surgeon. The graft stripping was performed by scoring and peeling method. Procedural metrics such as graft preparation time, loading and injecting time, unfolding time, and incidence of tears were recorded. The cumulative data was compared between the first and the last graft and subjected to One-way ANOVA with post-hoc Friedman's analysis for statistical purposes. 

Average donor graft preparation time for tissue 1, 2 and 3 was found to be 19.5+/-5.7, 15.8+/-4.5 and 12.6+/-4.7 minutes respectively, with a significant decrease betwen tissue 1 and 3 (p<0.0001). Donor graft loading and injection from tissue 1, 2 and 3 took an average of 8.3+/-4.7, 7.5+/-4.5 and 6.2+/-3.4 minutes respectively with a significant decrease observed between tissue 1 and 3 (p=0.0011). Donor DM unfolding was significantly decreased from tissue 1 to tissue 3 (p<0.0001) which showed 22.5+/-5.3 (tissue 1), 20.1+/-4.9 (tissue 2) and 17.9+/-6.4 (tissue 3) minutes.

Wetlab enhances surgeon skills in a risk-free environment and offers additional vital tool for training purposes with a potential to reduce waiting times and improve overall patient safety. Continued support for wetlab expansion is crucial, promoting wider adoption of DMEK surgery and ensuring high-quality patient care.