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Comparison between methods to prepare large donor grafts for DMEK

Poster Details

First Author: A.Tzamalis UK

Co Author(s):    V. Romano   E. Arbabi   R. Vinciguerra   D. Borroni   S. Kaye        

Abstract Details


To compare different techniques for large DMEK preparation.


St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK


In a prospective in vitro study, donor corneas for 9.5mm DMEK were prepared using three DMEK preparation methods. Stripping by punch method and a cystotome to identify the edge of Descemet’s membrane graft (group A); stripping from the trabecular meshwork using a crescent blade for 120 degrees (group B); utilizing a newly designed guarded “hinge” trephine (group C). Time for preparation, costs and damage to the endothelium was measured in 36 cases performed by 3 experienced and 3 novice surgeons.


In group A, the large DMEK graft was achieved in 66.6%(8/12) due to tearing. In groups B and C, 9.5mm DMEK grafts were reliably prepared by both novice and experienced surgeons without complication in all cases. No statistical significant difference in terms of damage to the endothelial cells was found. All techniques were similar in terms of costs. Group C yielded a shorter preparation time in comparison to the other study groups (p<0.01).


Endothelial graft harvesting using tenting of the donor cornea and peeling over 120 degrees from the trabecular meshwork or by means of a guarded “hinge” trephine may serve as good alternative methods to prepare large donor grafts for DMEK.

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