Early Experience With DMEK Using Novel Folding Insertion Technique

Sunday, April 27, 2014: 8:11 AM
Room 151B (Boston Convention and Exhibition Center)
M. Bowes Hamill, MD, Baylor college of medicine, Houston, Texas, USA
Sharmini A. Balakrishnan, MD, Baylor College of Medicine, Houston, TX, USA

Narrative Responses:

Purpose
To present our early experience with Descemet’s Membrane Endothelial Keratoplasty (DMEK) with special attention to a novel folding donor tissue insertion technique.

Methods
A retrospective review of the records of all patients having undergone DMEK by a single surgeon was undertaken. These records were reviewed for a number of variables including: tissue insertion technique, surgical complications, need for rebubbling, tissue detachment, primary graft failure, length of follow-up, visual acuity, and operative times. Additional variables to be evaluated will include: endothelial cell counts, visual outcome, and graft survival.

Results
To date 24 patients are included (14 with a novel folding technique and 10 with an injector technique). Rebubbling rates for the two groups were 42% folding group and 20% injector group.  1 patient in each group had a complete DMEK button detachment. Follow up is currently short (12 mos. for the folding group 3 mos. for the injector group) indicating our early experience. Vision is good with 57% of the folding group and 50% of the injector group seeing ≥ 20/30 at last follow up. Additional patients will be included in the review.

Conclusion
DMEK is a viable technique of endothelial transplantation. A novel folding donor tissue insertion technique may simplify the procedure and shorten operative times while maintaining good post operative outcomes. Additional conclusions will be included as data become available.