By Massimo Busin, MD; Vincenzo Scorcia, MD; Pia Easter Leon, MD
    AAO 2015
    Cornea/External Disease

    This video illustrates a technique to reduce surgical trauma and facilitate Descemet membrane endothelial keratoplasty (DMEK). The prestripped donor tissue is tri-folded, keeping the endothelium inward, and transferred onto a soft contact lens, which is then placed into the groove of a lens cartridge. A microincision forceps is inserted into the cartridge funnel filled with balanced salt solution to pull the donor tissue into the funnel itself while also maintaining the endothelium inward. The cartridge funnel is sealed with a piston and inserted into a nasal clear corneal incision. The microincision forceps is inserted through a temporal paracentesis and used to pull the graft into the anterior chamber, where it unfolds spontaneously under continuous irrigation and is then positioned with an air bubble.