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Updated: Jan 25, 2026
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Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
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Update on Descemet membrane endothelial keratoplasty
Joao V Godinho1, Shahzad I Mian
1Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
Current Opinion in Ophthalmology
|May 3, 2019
Summary
Descemet membrane endothelial keratoplasty (DMEK) is increasingly favored for endothelial failure. Innovations like preloaded grafts and partial DMEK techniques improve accessibility and outcomes, though endothelial cell density may be lower.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Transplantation Medicine
Background:
- Endothelial dysfunction is a leading cause of corneal opacity.
- Descemet membrane endothelial keratoplasty (DMEK) offers a tissue-sparing alternative to penetrating keratoplasty.
- Surgical challenges have historically limited widespread adoption of DMEK.
Purpose of the Study:
- To review recent advancements and new perspectives in Descemet membrane endothelial keratoplasty (DMEK).
- To highlight innovations addressing surgical challenges and cost-effectiveness.
- To compare outcomes of modified DMEK techniques with conventional DMEK.
Main Methods:
- Review of current literature and surgical techniques in DMEK.
- Analysis of outcomes data for preloaded DMEK, hemi-DMEK, and quarter-DMEK.
- Comparison of European and US surgical approaches.
Main Results:
- Preloaded DMEK grafts streamline surgery and reduce costs, facilitating wider use.
- Similar surgical outcomes are observed between US and European DMEK techniques.
- Hemi-DMEK and quarter-DMEK demonstrate comparable corneal transparency and visual acuity to standard DMEK.
- Three-year follow-up of hemi-DMEK shows stable corneal transparency and endothelial cell count.
Conclusions:
- DMEK is gaining acceptance as a primary treatment for endothelial failure.
- Preloaded grafts and partial DMEK techniques (hemi-DMEK, quarter-DMEK) enhance surgical feasibility and cost-effectiveness.
- While partial DMEK techniques achieve similar visual outcomes, they result in lower endothelial cell density.
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