Tips, Tricks, and Guides in Descemet Membrane Endothelial Keratoplasty Learning Curve

Davide Borroni; Carlos Rocha de Lossada; Mohit Parekh; Kunal Gadhvi; Chiara Bonzano; Vito Romano; Hannah J Levis; Aris Tzamalis; Bernhard Steger; Miguel Rechichi; Marina Rodriguez-Calvo-de-Mora

doi:10.1155/2021/1819454

Tips, Tricks, and Guides in Descemet Membrane Endothelial Keratoplasty Learning Curve

J Ophthalmol. 2021 Aug 17:2021:1819454. doi: 10.1155/2021/1819454. eCollection 2021.

Authors

Davide Borroni^{1

2}, Carlos Rocha de Lossada^{3

4}, Mohit Parekh⁵, Kunal Gadhvi⁶, Chiara Bonzano⁷, Vito Romano⁸, Hannah J Levis⁸, Aris Tzamalis⁹, Bernhard Steger¹⁰, Miguel Rechichi¹¹, Marina Rodriguez-Calvo-de-Mora^{12

13}

Affiliations

¹ International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy.
² Department of Doctoral Studies, Riga Stradins University, Riga, Latvia.
³ Department of Ophthalmology, University Hospital Virgen de Las Nieves, Granada 18014, Spain.
⁴ Department of Ophthalmology, Ceuta Medical Center, Ceuta 51001, Spain.
⁵ Institute of Ophthalmology, University College London, London, UK.
⁶ Department of Ophthalmology, Royal Liverpool University Hospital, Liverpool, UK.
⁷ Eye Clinic, DiNOGMI, University of Genoa and IRCCS San Martino Polyclinic Hospital, Genoa, Italy.
⁸ Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
⁹ 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
¹⁰ Department Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria.
¹¹ Centro Polispecialistico Mediterraneo, Sellia Marina, Italy.
¹² Department of Ophthalmology, Regional University Hospital of Malaga, Malaga 29010, Spain.
¹³ Department of Ophthalmology, Qvision (Vithas Almeria), Almería, Spain.

Abstract

Lamellar keratoplasty is fast becoming the most popular form of corneal transplantation. The adoption of Descemet membrane endothelial keratoplasty (DMEK) in the management of Fuchs endothelial dystrophy and pseudophakic bullous keratopathy is partly responsible for this shift in the paradigm of management of corneal pathology. The learning curve of DMEK, however, has been proven to be much steeper than previous endothelial keratoplasty procedures. To ease the procedure, experts have proposed multiple innovative techniques from tissue preparation to graft unfolding to aid the more novice surgeon. Here, we collate and share tips and tricks from our collective experiences to support the learning curve and outcomes in DMEK for both the novice and more experienced corneal transplant surgeons.

Publication types

Review