Related Experiment Video
Updated: Oct 1, 2025
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Long-Term Results of Postoperative Rescuing of Inverted DMEK Grafts: Two Case Reports
Mayte Ariño-Gutierrez1, Gregory Moloney2, Barbara Burgos-Blasco1
1Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Purpose:
The purpose of this study was to report the clinical outcomes of postoperative repositioning of 2 inverted Descemet membrane endothelial keratoplasty (DMEK) grafts in 2 patients with endothelial dysfunction.
Methods:
Two patients underwent DMEK surgery in a tertiary referral corneal clinic. Initial surgery was performed by 2 different corneal surgeons, and a third surgeon repositioned both cases. In the early postoperative period, partial and subtotal detachments were observed at slitlamp and inverted graft orientation was confirmed by anterior segment optical coherence tomography. In both cases, uneventful reposition of the inverted graft was performed by an experienced DMEK surgeon on days 2 and 9 after initial DMEK surgery.
Results:
Repositioning surgery was successful in both patients. The Moutsouris sign was used to confirm proper orientation. One patient had total graft adherence at day 1 postrepositioning. The second patient required a rebubbling procedure, despite the correct orientation confirmed by using anterior segment optical coherence tomography. Visual acuity and corneal thickness were stable in both cases (case 1: 20/30, 567 μm; case 2: 20/80, 543 μm). Both patients had clear corneas and functional cell counts 2 years after repositioning (451 cells/mm 2 and 1052 cells/mm 2 ).
Conclusions:
Postoperative repositioning of an inverted DMEK graft may be a viable procedure to delay or prevent regrafting.
