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Updated: Jun 5, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Descemet's membrane automated endothelial keratoplasty (DMAEK): visual outcomes and visual quality
Carlindo Da Reitz Pereira1, Frederico P Guerra, Francis W Price
1Price Vision Group, Indianapolis, Indiana, USA.
Background/Aims:
To determine whether the stromal rim that carries the bare endothelial graft in Descemet's membrane automated endothelial keratoplasty (DMAEK) has any effect on final visual outcome or visual quality.
Methods:
Twenty-four DMAEK eyes and 22 Descemet's membrane endothelial keratoplasty (DMEK) eyes (with no stromal rim) were evaluated for corrected distance acuity, full-field Humphrey visual field (VF) 120-2 and pupil size. The inner and outer diameter of the DMAEK stromal ring was measured from slit lamp photos. Patients completed a questionnaire rating postoperative symptoms and visual complaints. Exclusion criteria were pre-existing glaucoma, retinal pathology or inability to return for postoperative examinations.
Results:
Median Snellen acuities were comparable between DMAEK and DMEK groups: 20/25 and 20/20-3, respectively. The mean central opening of the DMAEK stromal ring was 5.6 × 5.5 (range 3.8-6.9) mm. The incidence of VF defects, visual complaints of glare, halos, light sensitivity and night driving difficulties was comparable between groups (all p > 0.1). A larger scotopic pupil size (< 5.5 mm) was not associated with increased incidence of VF defects in either group (p = 0.3).
Conclusions:
Surprisingly, compared with uniformly thin DMEK grafts, DMAEK grafts with a stromal rim had no increase in VF defects or visual complaints.
