Descemet membrane endothelial keratoplasty (DMEK)

Cornea. 2006 Sep;25(8):987-90. doi: 10.1097/01.ico.0000248385.16896.34.


Purpose: To describe Descemet membrane endothelial keratoplasty (DMEK) with organ cultured Descemet membrane (DM) in a human cadaver eye model and a patient with Fuchs endothelial dystrophy.

Methods: In 10 human cadaver eyes and 1 patient eye, a 3.5-mm clear corneal tunnel incision was made. The anterior chamber was filled with air, and the DM was stripped off from the posterior stroma. From organ-cultured donor corneo-scleral rims, 9.0-mm-diameter "DM rolls" were harvested. Each donor DM roll was inserted into a recipient anterior chamber, positioned onto the posterior stroma, and kept in position by completely filling the anterior chamber with air for 30 minutes.

Results: In all recipient eyes, the donor DM maintained its position after a 30-minute air-fill of the anterior chamber followed by an air-liquid exchange. In the patient's eye, 1 week after transplantation, best-corrected visual acuity was 1.0 (20/20) with the patient's preoperative refraction, and the endothelial cell density averaged 2350 cells/mm.

Conclusion: DMEK may provide quick visual rehabilitation in the treatment of corneal endothelial disorders by transplantation of an organ-cultured DM transplanted through a clear corneal tunnel incision. DMEK may be a highly accessible procedure to corneal surgeons, because donor DM sheets can be prepared from preserved corneo-scleral rims.

Publication types

  • Case Reports

MeSH terms

  • Corneal Transplantation / methods*
  • Descemet Membrane / surgery*
  • Endothelium, Corneal / surgery*
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Male
  • Middle Aged
  • Organ Culture Techniques
  • Tissue Donors
  • Visual Acuity / physiology