title: Hemi-Descemet membrane endothelial keratoplasty transplantation: a potential method for increasing the pool of endothelial graft tissue.
abstract: OBJECTIVE
  This study evaluates the technical feasibility and clinical outcomes of a Descemet membrane endothelial keratoplasty (DMEK) technique that could increase the availability of donor tissue for DMEK.
  
  
  OBJECTIVE
  To evaluate the clinical outcome of using a semicircular, large-diameter Descemet membrane graft in DMEK (hemi-DMEK), potentially allowing the use of a single donor cornea for 2 DMEK procedures.
  
  
  METHODS
  A prospective, interventional case series was conducted at a tertiary referral center. Three eyes of 3 patients with Fuchs endothelial dystrophy received a hemi-DMEK.
  
  
  METHODS
  Transplantation of a semicircular, large-diameter hemi-DMEK graft.
  
  
  METHODS
  Best-corrected visual acuity, endothelial cell density, pachymetry, and intraoperative and postoperative complications.
  
  
  RESULTS
  The patients' best-corrected visual acuity at 6 months was 0.70 (Snellen equivalent, 20/29), 0.50 (20/40 [amblyopic eye]), and 1.20 (20/17). At 1 month, endothelial cell density decreased by 49%, 31%, and 39%, respectively, and endothelial cell migration appeared to continue for up to 6 months. Central corneal thicknesses decreased from 682, 707, and 681 μm before surgery to 523, 534, and 489 μm, respectively, at 6 months. No intraoperative or postoperative complications were seen.
  
  
  CONCLUSIONS
  Hemi-DMEK (using half-moon-shaped grafts) is technically feasible and may provide visual outcomes similar to those obtained with routine DMEK (full-moon-shaped graft). If so, this technique may have the potential to double the availability of donor endothelial tissue for DMEK surgery.
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands.
authors.forename: Fook Chang
authors.initials: FC
authors.lastname: Lam
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands.
authors.forename: Lamis
authors.initials: L
authors.lastname: Baydoun
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands3Allgemeines Krankenhaus Linz, Linz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Dirisamer
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands4Amnitrans EyeBank Rotterdam, Rotterdam, the Netherlands.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lie
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands4Amnitrans EyeBank Rotterdam, Rotterdam, the Netherlands.
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D011446:Prospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014792:Visual Acuity / Q000502:physiology