title: Stromal support for Descemet's membrane endothelial keratoplasty.
abstract: OBJECTIVE
  To evaluate the use of a peripheral stromal support to facilitate and improve the outcomes of Descemet's membrane endothelial keratoplasty (DMEK).
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Ten patients with Fuchs' endothelial dystrophy.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Villa Serena Hospital, Department of Ophthalmology, Forlì, Italy. mbusin@yahoo.com
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
authors.forename: Amit K
authors.initials: AK
authors.lastname: Patel
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scorcia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Galan
authors.forename: Diego
authors.initials: D
authors.lastname: Ponzin
mesh_terms: D000368:Aged; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D003319:Corneal Stroma / Q000502:physiology*; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology