title: Descemet Membrane Endothelial Keratoplasty for a Decompensated Penetrating Keratoplasty Graft in the Presence of a Long Glaucoma Tube.
abstract: OBJECTIVE
  To describe specific maneuvers and technical modifications to the standardized "no-touch" technique of Descemet membrane endothelial keratoplasty (DMEK) to successfully handle the presence of a glaucoma drainage device (GDD) tube in the anterior chamber of an eye with a failed primary penetrating keratoplasty (PK) graft.
  
  
  METHODS
  A 42-year-old male patient underwent DMEK because of a failed primary PK graft in his phakic right eye. The patient was then evaluated at 3 and at 6 months after surgery.
  
  
  RESULTS
  A modified no-touch DMEK technique proved a feasible treatment option for a decompensated primary PK graft in the presence of a long GDD tube.
  
  
  CONCLUSIONS
  With specific technical modifications DMEK can be successfully performed in eyes with decompensated primary PK grafts in the presence of a long GDD tube. The very thin DMEK graft allows positioning between the GDD tube and the failed PK graft, leaving the tube in place.
authors.affiliation: *Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands; †Melles Cornea Clinic, Rotterdam, the Netherlands; ‡Naval Hospital, Athens, Greece; and §Amnitrans EyeBank, Rotterdam, the Netherlands.
authors.forename: Vasilios S
authors.initials: VS
authors.lastname: Liarakos
authors.forename: Maria
authors.initials: M
authors.lastname: Satué
authors.forename: Eitan
authors.initials: E
authors.lastname: Livny
authors.forename: Korine
authors.initials: K
authors.lastname: van Dijk
authors.forename: Lisanne
authors.initials: L
authors.lastname: Ham
authors.forename: Lamis
authors.initials: L
authors.lastname: Baydoun
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000601:surgery; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology*; D020327:Glaucoma Drainage Implants; D006084:Graft Rejection / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D019736:Prostheses and Implants; D017211:Treatment Failure