DMEK Surgical Strategy in Aphakic and Vitrectomized Eyes

Purpose After 15 years of accumulated experience in the Descemet Membrane Endothelial Keratoplasty (DMEK) technique, this surgical method has demonstrated a high reproducibility and success rate. However, certain ocular conditions such as aphakia and previously vitrectomized eyes remain challenging. We describe a novel technique designed to improve surgical time and postoperative outcomes in these specific scenarios.Methods Following delivery of the Descemet membrane graft into the anterior chamber (AC), a small air bubble was injected beneath the graft. One edge of the graft was grasped using the forceps. Subsequently, the external corneal surface was tapped, until the graft was unrolled.Results In our experience, this technique has consistently led to a reduced surgical time and excellent anatomical outcomes, achieving complete membrane attachment.Conclusions The technique developed and described herein provides a valuable surgical alternative for achieving successful DMEK outcomes in complex cases.