By Massimo Busin MD; Vincenzo Scorcia MD; Diego A Ponzin MD
    Cornea/External Disease

    This video illustrates a new surgical technique aimed at optimizing Descemet membrane endothelial keratoplasty (DMEK). Pneumatic dissection is used to separate the Descemet membrane and endothelium from the overlying stroma in a central area of the donor cornea, approximately 8.0 to 9.0 mm in diameter, and a graft of the same size is punched eccentrically to the detached area. The resulting peripheral sickle of stromal attachment is cut off the remaining stromal bed. The stromal support can be easily manipulated for atraumatic graft delivery and prevents the graft from rolling onto itself while identifying its endothelial side. Stromal support facilitates surgical manipulation, reduces surgical time, and minimizes complications of DMEK.