To describe Descemet membrane endothelial keratoplasty (DMEK) with organ cultured Descemet membrane (DM) in a human cadaver eye model and a patient with Fuchs endothelial dystrophy.
In 10 human cadaver eyes and 1 patient eye, a 3.5-mm clear corneal tunnel incision was made. The anterior chamber was filled with air, and the DM was stripped off from the posterior stroma. From organ-cultured donor corneo-scleral rims, 9.0-mm-diameter “DM rolls” were harvested. Each donor DM roll was inserted into a recipient anterior chamber, positioned onto the posterior stroma, and kept in position by completely filling the anterior chamber with air for 30 minutes.
In all recipient eyes, the donor DM maintained its position after a 30-minute air-fill of the anterior chamber followed by an air-liquid exchange. In the patient's eye, 1 week after transplantation, best-corrected visual acuity was 1.0 (20/20) with the patient's preoperative refraction, and the endothelial cell density averaged 2350 cells/mm2.
DMEK may provide quick visual rehabilitation in the treatment of corneal endothelial disorders by transplantation of an organ-cultured DM transplanted through a clear corneal tunnel incision. DMEK may be a highly accessible procedure to corneal surgeons, because donor DM sheets can be prepared from preserved corneo-scleral rims.