DMEK lenticule preparation using an air dissection technique: central versus peripheral injection

Area of Science:

• Ophthalmology
• Corneal Surgery
• Tissue Engineering

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure to restore vision.
• Donor lenticule preparation is critical for successful DMEK outcomes.
• Air injection is a common method for detaching the Descemet membrane (DM).

Purpose of the Study:

• To compare the efficacy of two air injection sites for preparing donor lenticules for DMEK.
• To evaluate the impact of central versus peripheral air injection on lenticule quality and usability.

Main Methods:

• Fifty-one human donor corneoscleral buttons were used.
• Air was injected either centrally within the 8-mm zone or peripherally near the limbus.
• Outcomes assessed included reproducibility, usable tissue rate, bubble characteristics, and graft type.

Main Results:

• Both central and peripheral air injection successfully created a 'big bubble' in all cases.
• Usable donor lenticules (≥ 8.0 mm) were obtained in 95.7% (central) and 89.3% (peripheral) of cases.
• Peripheral injection showed a higher likelihood (p=0.01) of yielding type 2 bubbles, indicative of stroma-free grafts.

Conclusions:

• Both central and peripheral air injection sites yield comparable rates of usable donor lenticules for DMEK.
• Peripheral air injection is more likely to result in stroma-free grafts, potentially improving surgical outcomes.