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Clinical results after single asymmetrical shark fin for graft orientation in DMEK

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Abstract

Purpose

Evaluating the effect of a single peripheral triangular mark to ensure the correct anterior–posterior graft orientation in DMEK.

Methods

Retrospective study of patients scheduled for DMEK due to Fuchs endothelial dystrophy and divided into 2 study groups: Group −M (n = 184) had no mark of the EDM (Endothelial Descemet membrane) and group + M (n = 193) had a triangular peripheral mark. Follow-up time was 1 year after surgery.

Results

The postoperative graft turning and Re-DMEK rate could be significantly reduced by the use of a peripheral mark (p = 0.002, p = 0.001, respectively). Re-DMEK due to primary graft failure was significantly associated with prior graft turning (p < 0.001). Both groups showed comparable values for visual acuity, central corneal thickness and endothelial cell count after a follow-up of 1 year.

Conclusion

Single peripheral triangular marking is a simple and cost-saving addition to EDM preparation to ensure the correct orientation of the graft intraoperatively and could lead to a significant reduction in graft turning and re-DMEK rate in this study.

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Data availability

All data are within the manuscript.

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Author information

Authors and Affiliations

  1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Germany

    Annekatrin Rickmann, Karl Boden, André M. Trouvain, Lisa J. Müller, Catheline Bocqué & Peter Szurman

  2. Klaus Heimann Eye Research Institute (KHERI), Knappschaft Hospital Saar, Sulzbach, Germany

    Karl Boden & Peter Szurman

  3. Centre for Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany

    Sebastian Thaler

Authors
  1. Annekatrin Rickmann
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  2. Karl Boden
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  3. André M. Trouvain
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  4. Lisa J. Müller
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  5. Catheline Bocqué
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  6. Sebastian Thaler
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  7. Peter Szurman
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Contributions

Conceptualization and Methodology: Annekatrin Rickmann, Peter Szurman; Formal analysis and investigation: Annekatrin Rickmann, André M. Trouvain, Lisa J. Müller; Writing—original draft preparation: Annekatrin Rickmann; Writing—review and editing: Peter Szurman, Annekatrin Rickmann, Karl Boden, André M. Trouvain, Lisa J. Müller, Catheline Bocqué, Sebastian Thaler. All authors have approved the submitted version.

Corresponding author

Correspondence to Annekatrin Rickmann.

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Conflicts of interest

Prof. Peter Szurman has a patent for a device for preparing and introducing a transplant or an implant into a living body, in particular for ophthalmological interventions: EP2533724 B1; WO2012065602 A3. All other authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All information is anonymized and the submission does not include images that may identify a person.

Ethical approval

The study was approved by the Ethics Committee of the Medical Association of Saarland (Ärztekammer Saarland, 254/16) and adheres to the tenets of the Declaration of Helsinki.

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Informed consent was obtained.

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Rickmann, A., Boden, K., Trouvain, A.M. et al. Clinical results after single asymmetrical shark fin for graft orientation in DMEK. Int Ophthalmol 42, 1061–1068 (2022). https://doi.org/10.1007/s10792-021-02091-7

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  • DOI: https://doi.org/10.1007/s10792-021-02091-7

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