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DMEK-S may pose alternative to regrafting after PK failure
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 Katerina Liehneova |
PRAGUE — Performing Descemet's membrane endothelial keratoplasty with a stromal rim, or DMEK-S, under a previous failed penetrating keratoplasty graft is a safe and effective method to avoid PK regrafting, according to one surgeon here.
"DMEK-S is a variation of DMEK where a stromal rim is left all around the central 6 mm Descemet's and endothelium graft to facilitate manipulation," Katerina Liehneova, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
DMEK-S was performed after failure of a previous PK graft in 11 eyes of 11 patients. The endothelial graft was inserted via the solution implantation technique with a cartridge.
"Typically in this procedure, the donor graft oversizes the PK lenticule by 1 mm. Stripping of Descemet's membrane is performed, and at the end of surgery, air bubble filling is done as in standard DMEK," Dr. Liehneova said.
PK had been performed once in five patients, twice in five patients, and four times in one patient.
In three patients DMEK-S was unsuccessful due to graft failure. In one of these patients a second DMEK-S was performed, while repeat PK was performed in two patients. Best corrected visual acuity improved in eight eyes. Re-bubbling was necessary in six patients.
"DMEK-S has the advantages of faster visual rehabilitation and less induced astigmatism," Dr. Liehneova said. "Globe integrity is preserved, with fewer risks compared to an open-sky procedure."
- Disclosure: Dr. Liehneova has no relevant financial disclosures.