DMEK
Descemet Membrane Endothelial Keratoplasty

Revolutionary system for treating endothelial corneal diseases

Corneal grafts are the most common tissue transplants. Many years ago, penetrating keratoplasty became clinical routine. But transplantation techniques have evolved, replacing perforation with lamellar keratoplasty.Almost half of all keratoplasties are performed to cure endothelial corneal diseases. In many cases, penetrating keratoplasty is excessive since the simple transplantation of vital endothelial cells would often suffice. This is why posterior lamellar techniques, especially DMEK, established as an alternative, widely atraumatic, solution for treating endothelial corneal diseases.DMEK (Descemet Membrane Endothelial Keratoplasty) is limited to the isolated Descemet membrane and endothelial cells without stroma, with a thickness of only approx. 15μm.

Clinical advantages of DMEK

Transplanting the extremely thin Descemet membrane offers faster visual recovery than other lamellar keratoplasty techniques. DMEK prevents interface problems, causes neither postoperative astigmatism nor myopia and substitutes more endothelial cells (up to 9.5 mm graft size). As a result, visual acuity improves in many cases by 0.8 or better after only one week. Due to these benefits, DMEK became a gold standard in the therapy of endothelial corneal diseases.

Instruments for standardizing DMEK

The success of this elegant technique is largely dependent on the number of vital endothelial cells and quality of the fragile graft and the gentle manipulation thereof. It is important that the fragile endothelial cells are not touched or stressed mechanically during preparation or implantation. In order to achieve reproducible results using a standardized technique and specific instruments, which ensure a touch-free surgical procedure, are necessary. The Liquid Bubble technique, which was developed in Sulzbach, Germany, uses a liquid for gentle separation of the Descemet membrane from the stroma beneath. It is another step towards the standardization of DMEK. On the following pages we have compiled a surgical set which will give experienced surgeons the opportunity to perform DMEK in the clinical routine. This set allows a touch-free preparation of the Descemet membrane and its subsequent transplantation.