New technique for endothelial grafts

Article

Looking at a new technique to prepare and transplant endothelial grafts usinf subendothelial air injections to separate donor Descemet and endothelium from overlying stroma.

Key Points

For this reason Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) was developed and in recent years it has gained widespread popularity. With this procedure the recipient cornea is maintained, with the exception of the complex Descemet membrane and endothelium, which are removed from the central part (usually 9 mm in diameter) of the posterior corneal surface. The donor graft consists of a thin lamella (usually between 100 µm and 200 µm in thickness) of deep stroma carrying the donor Descemet membrane and endothelium and is attached to the recipient cornea by means of an air bubble. Although cornea clarity is re-established by DSAEK in a relatively short period of time, the resulting stromal interface is considered by some authors a limiting factor for final visual acuity (VA).

From DSAEK to DMEK

Technical obstacles

To date, several technical problems relating to Dr Melles's technique have limited the popularity of DMEK among corneal surgeons. In particular, waste of donor tissue when detaching Descemet from overlying stroma should be avoided, while manipulation of donor tissue during delivery and positioning should be minimized.

First steps

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Christine Curcio, PhD, of the University of Alabama at Birmingham Heersink School of Medicine, shares histology update and revised nomenclature for OCT with Sheryl Stevenson of the Eye Care Network and Ophthalmology Times
SriniVas R. Sadda, MD, FARVO, shares key points from his retina presentation at the International SPECTRALIS Symposium
Robert Sergott, MD, describes fluorescence lifetime imaging ophthalmoscopy (FLIO) and the International SPECTRALIS Symposium – And Beyond (ISS) in Heidelberg, Germany.
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
ARVO 2025: Anat Loewenstein, MD, shares data from herself and her colleagues on meeting needs of patients with diabetic retinopathy
A photo of Seville, Spain, with the Congress on Controversies in Ophthalmology logo superimposed on it. Image credit: ©francovolpato – stock.adobe.com; logo courtesy COPHy
© 2025 MJH Life Sciences

All rights reserved.