Descemet membrane endothelial keratoplasty (DMEK): an update on safety, efficacy and patient selection

Figures & data

Figure 1 Note central DMEK graft detachment with corneal edema. Abbreviation: DMEK, descemet membrane endothelial keratoplasty.

Figure 2 AS-OCT showing a complete graft detachment with graft rescrolling at the anterior chamber angle.

Figure 3 Pupillary block caused by the air bubble.

Figure 4 Note the displacement of the air bubble to the posterior chamber.

Table 1 Comparison between DMEK and DSAEK regarding main differences

	DMEK	DSAEK
Faster visual recovery	X
Better visual outcome	X
Lower immune rejection rate	X
Less refractive error	X
ECC loss	Same	Same
Primary and secondary graft failure rate	Same	Same
Complications during and after surgery	Same	Same
Less technically challenging		X
Rebubble rate	May be higher (especially on initial learning curve)

Abbreviations: DMEK, descemet memebrane endothelial keratoplasty; DSAEK, descemet stripping automated endothelial keratoplasty; ECC, endothelial cell count.

Figure 5 Early (left) and late (right) post DMEK transplantation. Note the perfect anatomical replacement of this procedure.

Abbreviation: DMEK, descemet membrane endothelial keratoplasty.

Figure 6 Fuchs endothelial dystrophy. Note the central guttae.

Figure 7 DMEK graft to rescue a failed PK. Note the DMEK graft edge inside the original graft–host junction.

Abbreviations: DMEK, descemet membrane endothelial keratoplasty; PK, penetrating keratoplasty.