Use of accidentally torn descemet membrane to successfully complete descemet membrane endothelial keratoplasty.
OBJECTIVE
To describe the use of an accidentally torn Descemet membrane (DM) to successfully complete Descemet membrane endothelial keratoplasty (DMEK) surgery.


METHODS
Retrospective, observational case series of 3 eyes of 3 patients undergoing DMEK with a DM accidentally torn into 2 pieces during graft preparation. The mean outcome measures included best-corrected visual acuity, endothelial cell density, and central corneal thickness, before and at 1, 3, and 6 months after the DMEK surgery was performed.


RESULTS
During graft preparation, immediately before transplantation, a large tear within the 8.0-mm marking line of the DM occurred, resulting in a DM torn into 2 pieces. In all the eyes, both pieces were successfully implanted into the anterior chamber, unfolded and attached to the posterior corneal stroma, one after the other. Six months after the surgery was performed, the best-corrected visual acuity ranged between 20/30 and 20/25. Endothelial cell loss was about 30% (range 28%-32%) 6 months after the surgery. Pachymetry findings showed normal corneal thickness 6 months after the surgery. All corneas remained clear without any signs of graft failure within 6 months of follow-up.


CONCLUSIONS
DMEK surgery can be successfully completed despite the accidental tearing of donor DMs during the preparation of DMEK grafts by the sequential implantation of both DM pieces.
*Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen, Germany; and †Department of Ophthalmology, University of Cologne, Cologne, Germany.
Theofilos
T
Tourtas
Ludwig M
LM
Heindl
Nikolaos
N
Kopsachilis
Bjoern O
BO
Bachmann
Friedrich E
FE
Kruse
Claus
C
Cursiefen
D000368:Aged; D003886:Descemet Membrane / Q000293:injuries* / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity