title: Preliminary outcome of hemi-Descemet membrane endothelial keratoplasty for Fuchs endothelial dystrophy.
abstract: To evaluate the clinical outcome of a full-diameter, untrephined, semicircular Descemet graft in a consecutive series of Descemet membrane endothelial keratoplasty (hemi-DMEK), potentially allowing the harvesting of two grafts from a single donor corneoscleral rim.
  
  
  
  Interventional case series of 10 eyes of 10 patients with Fuchs endothelial dystrophy. Best corrected visual acuity (BCVA), endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated up to 6 months postoperatively, and intraoperative and postoperative complications were recorded.
  
  
  
  Hemi-DMEK was successful in 9 out of 10 eyes; one eye showed persistent graft detachment despite rebubbling and underwent a secondary DMEK. BCVA improved in all successful hemi-DMEK eyes: at 6 months 100% of eyes (n=7) reached ≥20/40 (≥0.5), 86% (n=6) ≥20/25 (≥0.8), 29% (n=2) ≥20/20 (≥1.0) and 14% (n=1) reached 20/17 (≥1.2). Two eyes were excluded from visual analysis due to low visual potential. Preoperative donor ECD declined from 2744 (±181) cells/mm2to 940 (±380) cells/mm2centrally at 6 months postoperatively (n=9), with (donor and/or host) endothelial cell redistribution over bare stromal areas adjacent to the graft. Average CCT decreased from 745 (±153) µm preoperatively to 520 (±37) µm at 6 months. Four eyes required rebubbling for visually significant graft detachment. No other complications occurred throughout the study period.
  
  
  
  Hemi-DMEK may give visual outcomes similar to those in conventional DMEK. If ECD decrease and graft detachment rate would prove acceptable in larger series, hemi-DMEK could have the potential to double the availability of donor tissue for endothelial keratoplasty.
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.
authors.forename: Nadine
authors.initials: N
authors.lastname: Gerber-Hollbach
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|UAB Callahan Eye Hospital, Birmingham, Alabama, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.|Amnitrans EyeBank, Rotterdam, The Netherlands.
authors.forename: Lamis
authors.initials: L
authors.lastname: Baydoun
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.
authors.forename: Vasilios S
authors.initials: VS
authors.lastname: Liarakos
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.|Amnitrans EyeBank, Rotterdam, The Netherlands.
authors.forename: Lisanne
authors.initials: L
authors.lastname: Ham
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dapena
authors.affiliation: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.|Melles Cornea Clinic, Rotterdam, The Netherlands.|Amnitrans EyeBank, Rotterdam, The Netherlands.
authors.forename: Gerrit Rj
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Cornea; Eye (Tissue) Banking; Treatment Surgery