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Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study

Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothel...

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Autores principales: Ariño-Gutierrez, Mayte, Molero-Senosiain, Mercedes, Burgos-Blasco, Barbara, Vidal-Villegas, Beatriz, Arriola-Villalobos, Pedro, Gegundez-Fernandez, Jose Antonio, Moloney, Gregory, Holguín, Luis Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573660/
https://www.ncbi.nlm.nih.gov/pubmed/37834961
http://dx.doi.org/10.3390/jcm12196316
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author Ariño-Gutierrez, Mayte
Molero-Senosiain, Mercedes
Burgos-Blasco, Barbara
Vidal-Villegas, Beatriz
Arriola-Villalobos, Pedro
Gegundez-Fernandez, Jose Antonio
Moloney, Gregory
Holguín, Luis Daniel
author_facet Ariño-Gutierrez, Mayte
Molero-Senosiain, Mercedes
Burgos-Blasco, Barbara
Vidal-Villegas, Beatriz
Arriola-Villalobos, Pedro
Gegundez-Fernandez, Jose Antonio
Moloney, Gregory
Holguín, Luis Daniel
author_sort Ariño-Gutierrez, Mayte
collection PubMed
description Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothelial cell dystrophy who underwent DMEK with very young donors (between 20 and 30 years old) were included. The following demographic data were assessed: donor’s age, donor’s endothelial cell density (ECD), preservation time, recipient’s age and sex and unfolding surgical time. Best-corrected visual acuity (BCVA; decimal system), ECD and corneal central thickness (CCT) were assessed preoperatively and at 6-month follow-up. Results: Donors’ mean age was 23.6 ± 3.6 years (range 21 to 30) and the mean ECD was 2748.6 ± 162.6 cells/mm(2). All of them underwent an uneventful DMEK as a single procedure performed by one experienced surgeon (MAG) with a mean unfolding time of 7.2 ± 4.9 min (range 4 to 15). The essential steps, including patient preparation as well as DMEK graft implantation, orientation, unrolling and centering are detailed. At 6 months, BCVA was 0.6 ± 0.2, ECD was 1945.0 ± 455.5 cells/mm(2) and CCT was 497.0 ± 19.7 microns. Conclusions: We hereby present the keys to overcome tightly scrolled grafts of very young donors, which prove perfectly suitable for DMEK surgery. The graft shape tends towards a double-roll and specific maneuvers are strongly recommended.
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spelling pubmed-105736602023-10-14 Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study Ariño-Gutierrez, Mayte Molero-Senosiain, Mercedes Burgos-Blasco, Barbara Vidal-Villegas, Beatriz Arriola-Villalobos, Pedro Gegundez-Fernandez, Jose Antonio Moloney, Gregory Holguín, Luis Daniel J Clin Med Article Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothelial cell dystrophy who underwent DMEK with very young donors (between 20 and 30 years old) were included. The following demographic data were assessed: donor’s age, donor’s endothelial cell density (ECD), preservation time, recipient’s age and sex and unfolding surgical time. Best-corrected visual acuity (BCVA; decimal system), ECD and corneal central thickness (CCT) were assessed preoperatively and at 6-month follow-up. Results: Donors’ mean age was 23.6 ± 3.6 years (range 21 to 30) and the mean ECD was 2748.6 ± 162.6 cells/mm(2). All of them underwent an uneventful DMEK as a single procedure performed by one experienced surgeon (MAG) with a mean unfolding time of 7.2 ± 4.9 min (range 4 to 15). The essential steps, including patient preparation as well as DMEK graft implantation, orientation, unrolling and centering are detailed. At 6 months, BCVA was 0.6 ± 0.2, ECD was 1945.0 ± 455.5 cells/mm(2) and CCT was 497.0 ± 19.7 microns. Conclusions: We hereby present the keys to overcome tightly scrolled grafts of very young donors, which prove perfectly suitable for DMEK surgery. The graft shape tends towards a double-roll and specific maneuvers are strongly recommended. MDPI 2023-09-30 /pmc/articles/PMC10573660/ /pubmed/37834961 http://dx.doi.org/10.3390/jcm12196316 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ariño-Gutierrez, Mayte
Molero-Senosiain, Mercedes
Burgos-Blasco, Barbara
Vidal-Villegas, Beatriz
Arriola-Villalobos, Pedro
Gegundez-Fernandez, Jose Antonio
Moloney, Gregory
Holguín, Luis Daniel
Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title_full Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title_fullStr Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title_full_unstemmed Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title_short Challenges of DMEK Technique with Young Corneal Donors’ Grafts: Surgical Keys for Success—A Pilot Study
title_sort challenges of dmek technique with young corneal donors’ grafts: surgical keys for success—a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573660/
https://www.ncbi.nlm.nih.gov/pubmed/37834961
http://dx.doi.org/10.3390/jcm12196316
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