Tips on DMEK Learning Curve to Make Surgical Steps Easier
Narrative Responses:
Purpose
To identify main difficulties and solutions on learning curve in Descemet’s Membrane Endothelial keratoplasty (DMEK).
Methods
A study evaluating the main difficulties and complications in the first 30 DMEK surgeries and most appropriate solutions for each complication was taken.
Results
Difficulties and solutions: preparing donor tissue(DT) / older corneas; small tears in DT / descemetorhexis curvilinear continuous; large tears in DT / release peripheral Descemet
introduce DT / anterior chamber depressurized; difficult to identify endothelial side / observation peripheral Descemet folds; unfold the DT 1 / older corneas; unfold the DT 2 / open roll 2 cannulae; keep the DT unfolded / anterior chamber shallow; good adherence of the DT / air bubble in center of the cornea; Detachment of peripherals Descemet / observation; Detachment of Descemet affecting visual axis / rebublle.
Conclusion
Difficulties on learning curve in Descemet’s Membrane Endothelial keratoplasty (DMEK) are best conducted using an appropriate technique.