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  • Title: Stromal support for Descemet's membrane endothelial keratoplasty.
    Author: Busin M, Patel AK, Scorcia V, Galan A, Ponzin D.
    Journal: Ophthalmology; 2010 Dec; 117(12):2273-7. PubMed ID: 20678800.
    Abstract:
    PURPOSE: To evaluate the use of a peripheral stromal support to facilitate and improve the outcomes of Descemet's membrane endothelial keratoplasty (DMEK). DESIGN: Prospective case series. PARTICIPANTS: Ten patients with Fuchs' endothelial dystrophy. INTERVENTION: Pneumatic dissection was used to detach the central part of the Descemet's membrane and endothelium from the deep stroma. Endothelial grafts including a peripheral stromal support were obtained by eccentric punching of donor tissue and used to perform DMEK surgery in 10 patients. MAIN OUTCOME MEASURES: Operative time, graft attachment rate, best spectacle-corrected visual acuity (BSCVA), endothelial cell loss, refraction, and complications. RESULTS: In all cases the surgical time was ≤ 1 hour. The postoperative course was uneventful in all but 2 cases, which required rebubbling owing to early graft detachment. Final attachment rate was 100%. The average follow-up was 8.4 months (range, 6-12). Postoperative BSCVA was ≥ 20/40 in all cases and no substantial change in refraction was recorded. Postoperative endothelial cell loss averaged 24.1% (range, 8%-34.9%). CONCLUSIONS: Stromal support facilitates surgery, reduces complications, and appears to maintain the favorable outcomes of DMEK.
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