Abstract
Purpose :
To create a corneal DMEK graft that allows the surgeon to better control orientation, centration and unrolling of the DMEK graft
Methods :
A novel corneal punch was designed to produce a DMEK graft with a tail. The graft was stained and loaded into a modified jones tube. The tail was grasped using a Tan forceps introduced through a contralateral 1.8mm incision. The graft was dragged into the anterior chamber and the tail was extravesated from the anterior chamber through the 1.8mm incision. The graft was then unrolled using the standard technique.
In 3 eyes of 3 patients with failed corneas; previous failed DSAEK plus Baerveldt tube, CMV endothelitis and Fuch's dystrophy were transplanted
Results :
In all 3 eye the graft was successfully attached. The new graft configuration allowed controlled introduction of the graft. It ensured orientation and allowed centration of the graft. In the first patient with previous failed DSAEK plus Baerveldt tube, the visual acuity improved at 1 month from CF to 6/12 The ECD at 3 months was 2100 cells/sqmm. In the other 2 eyes with fuchs' dystrophy the best corrected vision was 6/6 with 3 month postoperative ECD of 1400 and 2200 cells/sqmm.
Conclusions :
The novel DMEK punch can improve the surgeon's control during DMEK surgery
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.