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Updated: Oct 4, 2025

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DMEK Without Postoperative Supine Posturing.

Jack S Parker1,2, John S Parker1, Hudson Tate1

  • 1Parker Cornea, Birmingham, AL.

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|February 4, 2022
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Summary
This summary is machine-generated.

Eliminating postoperative supine positioning after Descemet membrane endothelial keratoplasty (DMEK) did not increase graft detachment risk. This finding is particularly relevant for bullous keratopathy patients, simplifying post-surgery recovery.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Transplantation

Background:

  • Descemet membrane endothelial keratoplasty (DMEK) is a common procedure for corneal endothelial dysfunction.
  • Standard post-operative care often includes prolonged supine positioning to ensure graft adherence.

Purpose of the Study:

  • To evaluate the incidence of graft detachment after DMEK without mandatory postoperative supine positioning.
  • To determine if eliminating supine posturing affects graft outcomes.

Main Methods:

  • 106 eyes (84 patients) with Fuchs endothelial corneal dystrophy or bullous keratopathy underwent DMEK with a 99% air bubble fill.
  • Patients recovered in an upright position and were discharged without supine posturing instructions.
  • Graft detachment was assessed using anterior segment optical coherence tomography at 1 day, 1 week, and 1 month.

Main Results:

  • Clinically significant graft detachment occurred in 22% of eyes (23/106) in the no-supine group.
  • The risk of detachment was not higher compared to historical controls with supine posturing.
  • Regrafting was needed in 6% of eyes for persistent detachment or graft failure.

Conclusions:

  • The requirement for supine posturing after DMEK can potentially be eliminated, especially for bullous keratopathy.
  • Eliminating supine positioning does not appear to increase the risk of clinically significant graft detachment.
  • This simplification may improve patient comfort and reduce healthcare burdens.