title: Case Report of Quarter-Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Dystrophy.
abstract: OBJECTIVE
  To describe a further modification of Descemet membrane endothelial keratoplasty (DMEK), using a quarter of an untrephined full-size donor Descemet membrane (DM) sheet ("Quarter-DMEK").
  
  
  METHODS
  A 58-year-old patient underwent Quarter-DMEK for Fuchs endothelial dystrophy in his pseudophakic right eye, with a single quadrant of a full-size, 11.5-mm-diameter DM graft.
  
  
  RESULTS
  Best-corrected visual acuity improved from 20/50 (0.4) before surgery to 20/40 (0.5) at 1 day, 20/30 (0.7) at 1 week, 20/25 (0.8) at 1 month and 20/20 (1.0) at 3 months after surgery. Central endothelial cell density decreased from 2700 cells/mm before surgery to 1551 cells/mm at 1 week, 1104 cells/mm at 1 month, and 846 cells/mm at 3 months after surgery. Pachymetry returned to normal values within the first month. No complications were observed.
  
  
  CONCLUSIONS
  Quarter-DMEK may give fast visual rehabilitation within the first month similar to visual outcomes after circular DMEK or semicircular DMEK (hemi-DMEK). If long-term endothelial cell density would prove acceptable in a larger number of cases, quarter-DMEK may have the potential to quadruple the availability of donor endothelial tissue for endothelial keratoplasty.
authors: *Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands; †Melles Cornea Clinic, Rotterdam, the Netherlands; and ‡Amnitrans EyeBank, Rotterdam, the Netherlands.
authors: Thomas M
authors: TM
authors: Müller
authors: Itay
authors: I
authors: Lavy
authors: Lamis
authors: L
authors: Baydoun
authors: Jessica T
authors: JT
authors: Lie
authors: Isabel
authors: I
authors: Dapena
authors: Gerrit R J
authors: GR
authors: Melles
mesh_terms: D003886:Descemet Membrane / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged