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Related Experiment Video

Updated: Oct 2, 2025

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

Published on: September 17, 2014

'Posture-Less' DMEK: Is Posturing After Descemet Membrane Endothelial Keratoplasty Actually Necessary?

Harry W Roberts¹, Vivienne Kit², Maria Phylactou¹

¹From Corneal and External Diseases Unit, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom (H.W.R, V.K, M.P, N.D, M.R.W).

American Journal of Ophthalmology

|March 1, 2022

Summary

Descemet membrane endothelial keratoplasty (DMEK) without posturing showed low graft detachment and complication rates. This "posture-less" DMEK technique offers a viable alternative for endothelial failure treatment.

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Last Updated: Oct 2, 2025

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

Published on: September 17, 2014

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Corneal Donor Tissue Preparation for Endothelial Keratoplasty

Published on: June 12, 2012

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Published on: May 5, 2022

Area of Science:

Ophthalmology
Corneal Surgery
Transplantation

Background:

Endothelial failure necessitates corneal transplantation.
Descemet membrane endothelial keratoplasty (DMEK) is a modern endothelial keratoplasty technique.
Traditional DMEK often requires specific patient posturing to ensure graft adhesion.

Purpose of the Study:

To evaluate the clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed without intraoperative or postoperative patient posturing.
To assess graft survival, complication rates, and visual acuity in posture-less DMEK.

Main Methods:

A retrospective, noncomparative, interventional case series of 134 eyes undergoing DMEK.
DMEK was performed with an intraoperative inferior peripheral iridectomy (PI) and intracameral 20% SF6 gas tamponade.
Patients did not undergo any intraoperative or postoperative posturing.

Main Results:

Graft detachment occurred in 3.7% (large) and 14.2% (small) of cases.
Rebubbling was needed in 14.2% of eyes.
Twelve-month graft survival was 91.0%, with a 6.7% rejection rate.

Conclusions:

Descemet membrane endothelial keratoplasty without posturing is associated with acceptable rates of graft detachment and rebubbling.
This 'posture-less' DMEK approach demonstrates favorable clinical results and can be considered for endothelial failure.
The technique minimizes patient discomfort and logistical challenges associated with traditional posturing protocols.