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Related Experiment Video

Updated: Feb 21, 2026

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
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Descemet Membrane Endothelial Transfer: Ultimate Outcome.

Rénuka S Birbal1,2,3, Jack Parker1,4, Martin Dirisamer1,2,5

  • 1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.

Cornea
|October 3, 2017
PubMed
Summary

Descemet membrane endothelial transfer (DMET) showed poor long-term outcomes for corneal endothelial dysfunction. Durable corneal clarity requires a fully attached Descemet graft, as partial attachment leads to decompensation and retransplantation needs.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Endothelial Keratoplasty

Background:

  • Descemet membrane endothelial keratoplasty (DMEK) and Descemet membrane endothelial transfer (DMET) are advanced corneal transplantation techniques.
  • Endothelial dysfunction, including Fuchs endothelial dystrophy and bullous keratopathy (BK), necessitates surgical intervention for vision restoration.
  • Graft attachment is a critical factor influencing the success of endothelial keratoplasty procedures.

Purpose of the Study:

  • To evaluate the clinical outcomes of 16 eyes undergoing Descemet membrane endothelial transfer (DMET).
  • To assess the long-term efficacy of DMET in patients with Fuchs endothelial dystrophy and bullous keratopathy.
  • To determine the impact of graft attachment on the success of DMET procedures.

Main Methods:

  • Retrospective cohort study of 16 eyes from 16 patients undergoing DMET or DMEK.
  • Patients had either Fuchs endothelial dystrophy (n=10) or bullous keratopathy (n=6).
  • Evaluation focused on graft attachment, corneal clearance, and postoperative complications.

Main Results:

  • Subtotal detachment of the Descemet graft complicated 8 Descemet membrane endothelial keratoplasty procedures.
  • DMET procedures were largely uneventful, with one case of wound leak in a BK patient.
  • All 16 corneas eventually decompensated, with 15 patients requiring retransplantation due to graft failure.

Conclusions:

  • Descemet membrane endothelial transfer (DMET) does not yield satisfactory long-term results for endothelial dysfunction.
  • Durable corneal clearance appears to depend on a nearly completely attached Descemet graft.
  • The study highlights the critical role of graft adherence in the success of endothelial keratoplasty.