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Surgeons find Descemet membrane endothelial keratoplasty (DMEK) adoption challenging due to technical difficulty and lack of experience. Addressing these barriers through training and support can increase DMEK use for endothelial dysfunction.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery

Background:

  • Endothelial dysfunction necessitates corneal transplantation.
  • Descemet membrane endothelial keratoplasty (DMEK) is an advanced endothelial keratoplasty technique.

Purpose of the Study:

  • To identify barriers and facilitators influencing the adoption of Descemet membrane endothelial keratoplasty (DMEK).

Main Methods:

  • Anonymous electronic surveys were distributed to 365 surgeons in the US who ordered corneal transplant tissue.
  • 118 surgeons (32%) completed the survey, providing data on their practice and DMEK adoption.

Main Results:

  • Surgeons not performing DMEK cited technical difficulty (63%), lack of experience (60%), and low volume (42%) as primary barriers.
  • Most non-DMEK surgeons (96%) expressed interest in learning the procedure.
  • Helpful resources identified include wet lab courses (73%), pre-prepared tissue (67%), and surgical mentorship (46%).

Conclusions:

  • A significant interest exists within the surgical community to adopt DMEK.
  • Targeted interventions addressing identified barriers can facilitate wider DMEK implementation.