‘Descemetorrhexis’ preps cornea for posterior lamellar transplant

A new technique allows excision of Descemet’s membrane in a controlled fashion without damage to the posterior corneal stroma, according to the technique’s developers. The “descemetorrhexis” quickly creates a stromal bed for implantation of a donor posterior lamellar disc in posterior lamellar keratoplasty, the developers said.

Gerrit R.J. Melles, MD, PhD, and colleagues at the Netherlands Institute for Innovative Ocular Surgery describe the technique in a report in Cornea. The authors excised the Descemet’s membranes from 10 human eye bank eyes and three patients to prepare them for posterior lamellar grafts.

In the technique, a 5-mm scleral tunnel incision was made in the recipient eyes, extending 1 mm into the peripheral cornea at the 12 o’clock surgical position. The anterior chamber was completely filled with air. A 9-mm mark was made on the corneal epithelium to outline the area where the Descemet’s membrane was to be removed. Descemet’s membrane was stripped off the posterior stroma by loosening the membrane at the 6 o’clock position and pulling to toward the 12 o’clock incision.

In all recipient eyes, the Descemet’s membrane could be easily and completely removed from the posterior corneal stroma, the authors reported. Microscopy showed isolated membranes without stromal tissue elements, they said.