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Peripheral stromal support may aid DMEK
Ophthalmology. 2010;117(12):2273-2277.
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Endothelial grafts with sickle-shaped peripheral stromal support may facilitate and reduce the complications of Descemet's membrane endothelial keratoplasty while maintaining favorable optical results and decreasing surgical time, a study found.
"This technique is considerably quick," the study authors said. "Preparation of donor tissue is simplified and the tissue handling and insertion is similar to that of DSAEK."
In the prospective case series, investigators evaluated 10 pseudophakic patients with Fuchs' endothelial dystrophy who underwent DMEK using endothelial grafts with sickle-shaped peripheral stromal support. Donor grafts consisted of a peripheral portion with stromal support attained through eccentric punching of the tissue. Average follow-up was 8.4 months.
Operating time averaged 50.7 minutes.
The investigators reported a final attachment rate of 100%. However, two patients experienced detachment of the endothelial portion of the graft at 1 day postop that required rebubbling to achieve graft attachment.
Best corrected visual acuity was 20/30 or better in nine patients and 20/40 in one patient. All patients' absolute value of astigmatism was within 0.5 D of the preoperative value, according to the study.
Endothelial cell loss averaged 24.1%.
No patients experienced visual complications due to the stromal support.