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Surv Ophthalmol. 2018 Mar - Apr;63(2):245-250. doi: 10.1016/j.survophthal.2017.07.003. Epub 2017 Jul 22.

Graft detachment and rebubbling rate in Descemet membrane endothelial keratoplasty.

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International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Mestre, Venice, Italy; Department of Molecular Medicine, School of Biomedicine, University of Padova, Padova, Italy. Electronic address:
Department of Ophthalmology, SS Giovanni and Paolo Hospital, Venice, Italy; Department of Ophthalmology, Villa Igea Hospital, Forli, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Mestre, Venice, Italy.
Department of Ophthalmology, Riga Stradins University, Riga, Latvia; Department of Genetics, Riga Stradins University, Riga, Latvia.
Moorfields Eye Hospital NHS Foundation Trust, London, UK.


Descemet membrane endothelial keratoplasty (DMEK) is a selective replacement of dysfunctional endothelium with healthy donor Descemet membrane and endothelium. Although the donor preparation and surgical methods still remain a challenge, DMEK is gaining popularity in terms of early rehabilitation and visual outcomes. New and improved donor preparation techniques like prestripped DMEK tissues are being taken up rapidly because of less manipulation that is required in the surgical theatre. Donor graft delivery in the recipient eye has also been improved because of new products like prestripped and preloaded membranes. As DMEK is at its budding stage, only early outcomes have been known so far. Early graft detachment, rebubbling rates, and primary failures are still being studied in DMEK. As there are different techniques that are currently used for preparation and injection of the graft, it becomes difficult to judge the results based on specific inclusion and exclusion criteria. Graft detachment and rebubbling rates have been a huge challenge both during the surgery and also while reporting postoperative data. We highlight the importance of defining graft detachment and rebubbling rates and their surgical relevance, which may also have an impact on graft preparation and insertion techniques.


DMEK; graft detachment; rebubble rate

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