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Updated: Apr 24, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Hemi-Descemet membrane endothelial keratoplasty transplantation: a potential method for increasing the pool of
Fook Chang Lam1, Lamis Baydoun1, Martin Dirisamer2
1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands2Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands.
Importance:
This study evaluates the technical feasibility and clinical outcomes of a Descemet membrane endothelial keratoplasty (DMEK) technique that could increase the availability of donor tissue for DMEK.
Objective:
To evaluate the clinical outcome of using a semicircular, large-diameter Descemet membrane graft in DMEK (hemi-DMEK), potentially allowing the use of a single donor cornea for 2 DMEK procedures.
Design, Setting, And Participants:
A prospective, interventional case series was conducted at a tertiary referral center. Three eyes of 3 patients with Fuchs endothelial dystrophy received a hemi-DMEK.
Intervention:
Transplantation of a semicircular, large-diameter hemi-DMEK graft.
Main Outcomes And Measures:
Best-corrected visual acuity, endothelial cell density, pachymetry, and intraoperative and postoperative complications.
Results:
The patients' best-corrected visual acuity at 6 months was 0.70 (Snellen equivalent, 20/29), 0.50 (20/40 [amblyopic eye]), and 1.20 (20/17). At 1 month, endothelial cell density decreased by 49%, 31%, and 39%, respectively, and endothelial cell migration appeared to continue for up to 6 months. Central corneal thicknesses decreased from 682, 707, and 681 μm before surgery to 523, 534, and 489 μm, respectively, at 6 months. No intraoperative or postoperative complications were seen.
Conclusions And Relevance:
Hemi-DMEK (using half-moon-shaped grafts) is technically feasible and may provide visual outcomes similar to those obtained with routine DMEK (full-moon-shaped graft). If so, this technique may have the potential to double the availability of donor endothelial tissue for DMEK surgery.
