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Successful DMEK After Intraoperative Graft Inversion

Yu, Charles Q. MD; Ta, Christopher N. MD; Terry, Mark A. MD; Lin, Charles C. MD

doi: 10.1097/ICO.0000000000000311
Case Report

Purpose: Hardiness of a Descemet membrane endothelial keratoplasty (DMEK) graft is not well established. The aim of this study was to report a case of graft survival after intraoperative inversion.

Methods: We describe a case of a 76-year-old man with Fuchs corneal dystrophy who underwent DMEK in the left eye. After deployment of the graft and a 15-minute sulfur hexafluoride gas fill, the graft was noted to be inverted. The graft was then reoriented and properly positioned.

Results: Because of progressive graft detachment, rebubble was required at 2 weeks after surgery. At 2 months after surgery, the graft was clear and fully adherent. Specular microscopy revealed 27.9% endothelial cell loss of the donor cornea.

Conclusions: Despite intraoperative inversion, this DMEK graft remained viable without excessive endothelial cell loss.

*Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA;

Corneal Services, Devers Eye Institute, Portland, OR; and

Department of Ophthalmology, Weill Cornell Medical College, New York, NY.

Reprints: Charles C. Lin, MD, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94304 (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received August 29, 2014

Received in revised form October 06, 2014

Accepted October 08, 2014

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