Avoiding errors when converting to DMEK


Prof. Martin Dirisamer discusses his instructional course on common mistakes when performing DMEK and how to avoid them at ESCRS.

Video transcript

Note: This transcript has been lightly edited for clarity.

Caroline Richards: So thank you for joining me at this year's ESCRS, Professor Dirisamer. I understand tomorrow you're due to present on DMEK. I would love to hear more about that. Could you tell me the key takeaways from the instructional course?

Prof. Martin Dirisamer: Yeah, thank you for the kind invitation. Yeah, we are having a course about DMEK and how to avoid mistakes in converting to DMEK because it was like a kind of transformation from PK and DSAEK. And, you know, obviously, mistakes we made, we try to [make it so] the younger people do not have to do the same mistakes. Well, it's about the indication, how to start and what are the key points where I can avoid complications, and to get together the perfect outcomes.

So it's, I think, very important for a beginner to start with DMEK, to pick up easy cases. So not start with challenging cases. But pick easy cases. And from there, follow certain rules. So if you follow these rules, and these suggestions, I think it could do this transformation pretty easily.

Richards: And so do you think that'll be a good uptake on DMEK in and amongst the younger ophthalmologists?

Dirisamer: Yes, I think it's, at least in German-speaking countries, I think the most popular transportation. And so I think the younger colleagues, they started with us; in my case, it was the same thing. So I think you can kind of overtake the other data procedures that don't have to DSAEK anymore. They can start right away with DMEK.

And, yes, so we tried to give them a kind of stepwise approach to solve problems we have to face in the beginning with DMEK. And, yeah, I think this could work out for most people. Of course, you need some surgical skills, you need some surgical training as well. But you also should be aware of the theory behind.

Richards: Yeah, yeah.

Dirisamer: Yeah, that's I think that for younger people and younger colleagues, I think this might be a good basis.

Richards: Yeah. And what would you say the main challenges in performing this procedure? What goes wrong most often?

Dirisamer: I would say the most the most challenging part is that it's basically a two-step surgical procedure, so you have to prepare your graft, sometimes on your own. Of course, there's prepared tissue available, but in many parts of the world, there is not. So you have to prepare the tissue both by yourself; this is the first challenge. You have a challenge already, and the surgery part hasn't even started.

Richards: Yes, yeah, I see.

Dirisamer: Of course, you have to know how to store this tissue, how to stain it. And so it's a combination of many things. I would say complication number one, if you make a sealed [audio unclear] detachment. But on the other, the other side, it's not a big complication. You can solve it pretty easy. But it's better to avoid it. So we do everything that we can to not get a complication, and there's some tips and tricks, how you can do that.

Richards: All right. Well, it sounds like it would be a great course for ophthalmologists to attend tomorrow. I'm sure they're very much looking forward to learning more.

Dirisamer: It's always packed, so.

Richards: Yeah, oh well, I can imagine. It sounds really interesting. Thank you very much for sharing that with me here.

Dirisamer: It's a pleasure.

Richards: Here in sunny Milan.

Dirisamer: It's a pleasure.

Richards: Thank you very much.

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