Unfolding Techniques for the DMEK Graft
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In Descemet membrane endothelial keratoplasty (DMEK), graft unfolding is often perceived as the most difficult step and the most challenging to learn [1–3]. Of course, the best way to learn anything is by practice, and for DMEK surgery, there exist both an animal eye model  and a method for simulating the operation using an artificial anterior chamber (which is how we teach graft unfolding at our wet-lab courses). Beginning surgeons may also be comforted to know that most clinical outcomes during the “learning curve” of the operation approximate those obtained by more experienced hands [5–7].
KeywordsAnterior Chamber Endothelial Cell Density Double Roll Single Roll Shallow Anterior Chamber
- 7.Monnereau C, Quilendrino R, Dapena I, Liarakos VS, Alfonso JF, Arnalich-Montiel F, Böhnke M, Cesário Pereira N, Dirisamer M, Parker J, Droutsas K, Geerling G, Gerten G, Hashemi H, Kobayashi A, Naveiras M, Oganesyan O, Orduña Domingo E, Priglinger S, Stodulka P, Torrano Silva Jr J, Venzano D, Vetter JM, Yiu E, Melles GRM. Multicenter study on Descemet membrane endothelial keratoplasty: first case series of 18 surgeons. JAMA Ophthalmol. 2014;132:1192–8.CrossRefPubMedGoogle Scholar
- 20.Melles GRJ, Dapena I. Chapter 4, ‘No-touch’ DMEK surgical technique. In: How to get started with standardized ‘no-touch’ Descemet membrane endothelial keratoplasty (DMEK). Rotterdam: Netherlands Institute for Innovative Ocular Surgery; 2014. p. 57–72.Google Scholar