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Simple, Inexpensive, and Effective Injector for Descemet Membrane Endothelial Keratoplasty

Kim, Eun Chul MD, PhD; Bonfadini, Gustavo MD; Todd, Leisha RN, CNOR; Zhu, Angela BSc; Jun, Albert S. MD, PhD

doi: 10.1097/ICO.0000000000000121

Purpose: We describe an inexpensive, simple, and effective endothelium–Descemet membrane (EDM) graft injector assembled from regular operating room supplies in Descemet membrane endothelial keratoplasty (DMEK).

Methods: To assemble the injector, standard intravenous tubing was cut approximately 2 inches from the Luer lock end, leaving a steep bevel. The cut end of the tubing was firmly wedged bevel up and advanced into the back of an Alcon IOL B cartridge. The Luer lock end of the tubing was then attached to a 5- or 10-mL syringe filled with BSS Plus. The EDM graft was then placed into a Petri dish filled with BSS. After the graft was sucked into an injector with bevel-side up under the surgical microscope, the graft was then inserted into the anterior chamber with the injector through the main incision in the superotemporal quadrant.

Results: In seven eyes of seven patients with Fuchs endothelial corneal dystrophy treated with DMEK using our injector, clear attached grafts and improved visual acuity were achieved.

Conclusions: This simple, inexpensive, and effective injector is a safe and viable device to facilitate this part of DMEK surgery.

Supplemental Digital Content is Available in the Text.

*Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD; and

Department of Ophthalmology and Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.

Reprints: Albert S. Jun, 400 N. Broadway, Smith 5011, Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21231 (e-mail:

Supported by grants from the J. Willard and Alice S. Marriott Foundation, Edward Colburn, Lorraine Collins, Richard Dianich, Mary Finegan, Barbara Freeman, Stanley Friedler, Herbert Kasoff, Diane Kemker, Jean Mattison, Lee Silverman, and Norman Tunkel (A.S.J.).

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received January 14, 2014

Accepted March 03, 2014

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.