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New technique may overtake concept of graft surgery in endothelial reconstruction
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MILAN — Endothelial regeneration in eyes with Fuchs’ dystrophy may be possible with a “no touch, no graft” technique, according to an endothelial transplantation pioneer.
Gerrit Melles, MD, spoke about his new Descemet’s membrane endothelial transfer (DMET) technique at the EuCornea congress. He said that the idea came from the observation that in some eyes corneal clearance occurred despite endothelial graft detachment or subtotal attachment after Descemet’s membrane endothelial keratoplasty.
“This occurred in Fuchs’ eyes and not in bullous keratopathy eyes because Fuchs’ is a potentially reversible endothelial cell dysfunction. This was a proof that host cells are somehow involved and can start migrating again under the regenerating stimulus of the donor,” Melles said.
These findings might completely change the approach to corneal transplantation.
“In 10 years, graft surgery might be ancient history and stimulating agents may be used instead to reconstruct diseased tissues,” Melles said.
Melles and his group are currently evaluating the potential effects of DMET in eyes in which DMEK cannot be performed.
“We place a roll of donor tissue, the same that we would implant in DMEK, into the anterior chamber and wait for the results,” he said.
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Disclosure: Melles has no relevant financial disclosures.