DMEK surgery for Fuchs' dystrophy - surgical steps

This is an image sequence from a recent surgery for a patient with Fuchs' dystrophy. The photo montage shows the surgical steps of DMEK (descemets membrane endothelial keratoplasty) surgery. The surgery is performed through a 3mm keyhole incision. Visual recovery is rapid and rejection rates are significantly lower than DSAEK. This patient had 6/6 (20:20) vision at 1 week!

DMEK for Fuchs Dystrophy

Surgical steps of DMEK.

a. Descemetorhexis under air

b. DMEK graft stained with tryphan blue to aid visualisation inserted by glass injector

c. DMEK roll in anterior chamber (AC)

d. Unfolding DMEK by tapping

e. Further unrolling of the DMEK scroll 

f. Small gas bubble inserted to flatten edges (bubble‐bumping manoeuvre);

g. SF6 gas tamponade;

h. End of case. The AC is full of gas.

Posted on May 7, 2015 .