Stromal support for Descemet's membrane endothelial keratoplasty.
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.
Busin
Massimo
M
Villa Serena Hospital, Department of Ophthalmology, Forlì, Italy. mbusin@yahoo.com
Patel
Amit K
AK
Scorcia
Vincenzo
V
Galan
Alessandro
A
Ponzin
Diego
D
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