MAR 30, 2020
DMEK Scroll-Y-Tales
AAO 2019 Video Program
Cornea/External Disease
This video demonstrates different types of surgeon-prepared Descemet membrane (DM) scrolls and their behavior in a BSS-filled petri dish. They are the Classic and Reverse Double Scroll, the Tight and Not-So-Tight Scroll, the Half and Reverse Half Scroll and the No Scroll (flat DM). We believe that this observation is important just before donor loading in an IOL-cartridge system. For any type of scroll, donor aspiration is easy with the “bevel-up” injector cartridge, and during donor insertion, it is always in the “bevel-down” entry position. After loading, we demonstrate orientation of the “S” mark within the cartridge in a bevel-down position against a white background just before injection. If the “S” is right after entering into the anterior chamber (AC), inject directly in bevel-down position. If the “S” is reversed, rotate the cartridge inside the AC and then inject in the bevel-up position. If not sure about the orientation of the “S”, inject directly as bevel-down. With these changes in the last 125 eyes, mean donor unscrolling time was reduced to 68.1 ± 16.4 seconds