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27th International Congress of German Ophthalmic Surgeons

15. to 17.05.2014, Nürnberg

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Hemi-DMEK transplantation – a novel method for increasing the pool of endothelial graft tissue (B)

Meeting Abstract

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  • Lamis Baydoun - Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Niederlande
  • Fook Chang Lam - Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Niederlande
  • Martin Dirisamer - Allgemeines Krankenhaus Linz, Linz, Österreich
  • Jessica Lie - Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Niederlande
  • Isabel Dapena - Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Niederlande
  • Gerrit R. J. Melles - Netherlands Institute for Innovative Ocular Surgery, Rotterdam, Niederlande

27. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 15.-17.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocWK 4.18

doi: 10.3205/14doc132, urn:nbn:de:0183-14doc1321

Published: May 5, 2014

© 2014 Baydoun et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Purpose: To evaluate the clinical outcome of using a semicircular Descemet graft in Descemet membrane endothelial keratoplasty (hemi-DMEK), potentially allowing the use of a single donor cornea for two endothelial keratoplasty procedures.

Methods: A prospective evaluation of the technical feasibility and clinical outcome of hemi-DMEK in three eyes of three patients with Fuchs endothelial dystrophy.

Main outcome measures: Best corrected visual acuity (BCVA), endothelial cell density (ECD), pachymetry, and intra- and postoperative complications.

Results: BCVAs at 6 months were 20/28 (0.7), 20/40 (0.5; amblyopic eye) and 20/17 (1.2). At 1 month, ECD decreased 31–49%, and endothelial cell migration appeared to continue up to six months. Central corneal thicknesses decreased from 682–707 μm before surgery to 489–534 μm at 6 months. No intra- or postoperative complications were seen.

Conclusions: Hemi-DMEK (using half-moon shaped grafts) proved technically feasible and may give visual outcomes similar to those in routine DMEK (full-moon shaped graft). If so, this technique may have the potential to double the availability of donor endothelial tissue for DMEK surgery.