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ABSTRACT: Purpose of review
To review the current literature on Descemet membrane endothelial keratoplasty (DMEK) in complex eyes.Recent findings
DMEK surgery has become a standardized procedure in Fuchs endothelial dystrophy and simple bullous keratopathy. But eyes with more complex disease present unique intraoperative and postoperative challenges to the DMEK surgeon. Poor visualization during surgery, complex anterior segment anatomy, altered anterior chamber dynamics, glaucoma shunts, and congenital or iatrogenic missing or altered iris and lens make DMEK surgery extremely difficult to accomplish.Summary
DMEK is feasible in complex eyes, including advanced bullous keratopathy, eyes with history of glaucoma or vitreoretinal surgery, previous penetrating keratoplasty, uveitis, pediatric, and congenital anterior segment disorders. The tools and methods reported in the literature to accomplish DMEK in complex eyes vary widely with no particular consensus or standardization of techniques. The outcomes noted for some of these conditions demonstrate the difficulty of the surgery and the uncertainty of long-term graft survival in complex eyes. Both surgical standardization and randomized prospective data will better help elucidate DMEK's role in the corneal rehabilitation of complex eyes.
SUBMITTER: Siddiqui A
PROVIDER: S-EPMC9261113 | biostudies-literature | 2022 Jul
REPOSITORIES: biostudies-literature
Siddiqui Aazim A Chamberlain Winston D WD
Current opinion in ophthalmology 20220701 4
<h4>Purpose of review</h4>To review the current literature on Descemet membrane endothelial keratoplasty (DMEK) in complex eyes.<h4>Recent findings</h4>DMEK surgery has become a standardized procedure in Fuchs endothelial dystrophy and simple bullous keratopathy. But eyes with more complex disease present unique intraoperative and postoperative challenges to the DMEK surgeon. Poor visualization during surgery, complex anterior segment anatomy, altered anterior chamber dynamics, glaucoma shunts, ...[more]