ESCRS - POCOR280 - An Analysis Of The Unfolding Pattern Of No-Touch Endo In Dmek

An Analysis Of The Unfolding Pattern Of No-Touch Endo In Dmek

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR280 | Type: Free paper | DOI: 10.82333/3e2m-cd03

Authors: Dr Leonard Goussard Heydenrych* 1 , Dr Eric Abdullayev 2 , Dr Benjamin Lambright 3 , Mr Arthur Kurz 4

1Cornea and External Eye Disease,Port Elizabeth Provincial Hospital and University of Cape Town,Port Elizabeth,South Africa, 2Innovation,Lions World Vision Institute,Tampa,United States, 3Medical Director,Lions World Vision Institute,Tampa,United States, 4Director,Lions World Vision Institute,Tampa,United States

Purpose

To review if pre-loaded Endo-In DMEK (Descemet Membrane Endothelial Keratoplasty) grafts unfold in specific patterns after insertion into the anterior chamber.

Setting

All DMEK grafts were pre-loaded at the Lions World Vision Institute (Tampa, USA) in a specially designed cannula and shipped to South Africa. All surgeries were performed at the Cape Eye Hospital in Cape Town.

Methods

Real time videos of recorded Endo-In DMEK surgeries were analyzed. Grafts were inserted into the anterior chamber via fluid injection by connecting the cannula to a 3 mL syringe.The mean time to unfold grafts were calculated as well as the mean number of taps required to unfold grafts. The mean endothelial cell densities (ECD) were calculated at final visit. Graft unfolding was classified as complete unfolding (at least 90 % of graft open), partial unfolding with external manipulation leading to complete unfolding and external tapping leading to complete unfolding.

Results

45 real-time videos of 45 Endo-In DMEK surgeries were reviewed. Endo-In DMEK required a mean of 21.18 seconds and 16.24 taps to unfold the grafts completely. 30 grafts unfolded completely (66.67%), 6 grafts required external manipulation (13.33%) and 9 grafts required external tapping (20%) to completely unfold grafts. Mean ECD at final visit was 1309.81 cells/mm2 (±199.625).

Conclusions

In this surgical analysis of No-touch Endo-In DMEK, most grafts (66.67%) opened completely without any external manipulation. Approximately a third of the grafts (33.33%) required some form of tapping or manipulation to completely unfold grafts.