January 25, 2013
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DMEK minimizes drawbacks of PK

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WAIKOLOA, Hawaii — Endothelial keratoplasty procedures only replace the part of the cornea that is dysfunctional, making them potentially safer and yielding better visual results compared with penetrating keratoplasty, a speaker said here.

“As we get more experience, we are becoming more exact in the way that we do the tissue replacement,” Francis W. Price Jr., MD, said at Hawaiian Eye 2013.

Descemet’s stripping endothelial keratoplasty is the most common form of standard care for epithelial dysfunction, Price said, and it has had a dramatic impact on people’s lives.

Francis W. Price Jr., MD

Francis W. Price Jr.

“[Patients] go back to work in 1 to 3 weeks, and there is absolutely no restriction on their activities after 2 months. That’s just a huge improvement over PK,” Price said.

Whereas DSEK is a good choice for epithelial dysfunction, in Price’s opinion, Descemet’s membrane endothelial keratoplasty is even better. The drawback is that DMEK is a more intricate procedure and takes time to learn.

The “four scourges” of PK, according to Price, are ocular surface disease, structural deficiencies such as astigmatism and weak wounds, immunologic graft reactions, and glaucoma.

“DSEK eliminated the first two, and now DMEK is greatly diminishing the risk of immunologic graft rejection and secondary glaucoma,” Price said.

Disclosure: Price has no relevant financial disclosures.