Surgical goniolens for tag identification and removal in DMEK surgery

Eur J Ophthalmol. 2023 May;33(3):1480-1483. doi: 10.1177/11206721221149482. Epub 2022 Dec 28.

Abstract

Introduction: We describe a novel technique for identifying endothelial Descemet membrane (DM) tags remaining after descemetorhexis in patients undergoing Descemet membrane endothelial keratoplasty (DMEK) surgery.

Methods: A surgical goniolens is applied to the corneal surface after descemetorhexis in order to visualize the peripheral inner corneal layer at 360° and identify endothelial-DM tags.

Results: A detailed visualization of the peripheral inner corneal layer is possible using goniolens, without using any staining in the anterior chamber.

Conclusion: The technique may be used to screen the posterior corneal surface for any retained endothelial-DM tags. It may to lower the risk of remaining tags and indirectly lower the incidence of DMEK graft detachment.

Keywords: Cornea; DMEK; gonio lens; graft detachment; tags.

MeSH terms

  • Cornea
  • Corneal Diseases* / surgery
  • Descemet Membrane / surgery
  • Descemet Stripping Endothelial Keratoplasty* / methods
  • Endothelium, Corneal / transplantation
  • Fuchs' Endothelial Dystrophy* / surgery
  • Humans
  • Retrospective Studies
  • Visual Acuity