DMEK or Descemet membrane endothelial keratoplasty
El DMEK or descemet membrane endothelial keratoplasty is a surgical technique of corneal transplant selective, that is, only the corneal endothelium and Descemet's membrane are transplanted without affecting the other layers of the cornea, which offers a minor trauma and a better visual recovery.
The cornea is composed of different layers and the corneal endothelium is the one with the greatest depth. The function of the endothelium is let the aqueous humor inside the cornea and remove it later to avoid an accumulation of it.
DMEK or Descemet membrane endothelial keratoplasty
El DMEK or descemet membrane endothelial keratoplasty is a surgical technique of corneal transplant selective, that is, only the corneal endothelium and Descemet's membrane are transplanted without affecting the other layers of the cornea, which offers a minor trauma and a better visual recovery.
The cornea is composed of different layers and the corneal endothelium is the one with the greatest depth. The function of the endothelium is let the aqueous humor inside the cornea and remove it later to avoid an accumulation of it.
What is DMEK surgery?
La DMEK: Descemet membrane endothelial keratoplasty, is one of the two surgical techniques that we perform to make a partial cornea transplant. That is, only in the endothelial layer. Other surgical technique is known as DSAEK.
El target of the intervention is selectively remove diseased endothelial cell tissue and replace it with healthy one, extracted from the cornea of a donor.
La Descemet membrane is one of the six layers that make up the cornea, a cellless tissue that lies between the endothelium and the stroma. Surgery DMEK allows the endothelium to be selectively removed no need to touch the other layers of the cornea.
For this reason the DMEK technique is, at present, the Most commonly used technique to perform endothelial keratoplasty. He endothelial transplant, is an intervention that is not performed in all ophthalmological centers due to its complexity and high surgical requirement. In Área Oftalmológica Avanzada as experts in surgery DMEK.
When is this endothelial transplant indicated?
La Descemet's membrane endothelial keratoplasty is performed when a patient has problems with the endothelium of the cornea, the deepest layer of the tissue that is made up of flat cells and is responsible for keeping the cornea nourished, allowing the passage of aqueous humor into the interior of the cornea and later removing it to avoid thickening due to accumulation.
The endothelial problems currently represent the 60% of corneal transplant cases.
La corneal opacity congenital or secondary, the keratoconus and posterior polymorph endothelial corneal dystrophy are the cmost common auses of endothelial damage.
The secondary trauma in surgeries y accidental trauma they can also be reason for corneal endothelial transplantation.
How is the operation?
When talking about corneal endothelial transplantation, it can be inferred that it is a complicated and high-risk surgery.
Fortunately, ophthalmology has advanced so much that today it is possible to transplant tissue with sufficient safety rates to enter the operating room alone if you have a expert surgeon or with a surgical center with the necessary technology.
Let's meet next how a DMEK is done.
Before the intervention
Before starting DMEK surgery, it is necessary for the patient to undergo a complete eye examination so that the doctor can examine the state of the ocular structure and determine if is a candidate or not a keratoplasty.
La Descemet membrane endothelial keratoplasty has the same risks as minor surgery, so it does not represent a greater danger to health.
El process is ambulatory and patient can go home the same day of the intervention with a series of indications of the doctor.
During the intervention
For perform the DMEK, the ophthalmologist will apply anesthetic drops local and a small patient sedation.
With the anesthetized eye, the doctor will perform a microincision to remove damaged tissue and place healthy tissue.
The whole process lasts up to 20 minutes.
DMEK postoperative
El postoperative of a DMEK its alot simpler than other corneal transplant techniques, since only the affected tissue is transplanted and the cornea is not transplanted in its entirety (penetrating transplant).
Therefore, the recovery process is much faster than other types of keratoplasty and corneal surgeries.
After the intervention the doctor is likely to prescribe eye drops for the eyes and some pain reliever.
This technique offers a 95% vision recovery and only 3% of cases show transplant rejection.
DMEK benefits
The DMEK or Descemet membrane endothelial keratoplasty is the most revolutionary technique today for endothelial transplantation because it allows transplant only the affected tissue without touching the rest of the layers of the cornea.
The rrecovery of the patient after DMEK es much faster that in a penetrating transplant due to its selective character. Since the DMEK acts only on damaged layers, it offers best visual results and a much faster visual recovery.
Differences between DSAEK vs DMEK
Descemet's membrane endothelial keratoplasty (DMEK) y automated endothelial keratoplasty with stripping of Descemet's membrane (DSAEK) they have the same objective, replace the damaged endothelium with a new and healthy tissue.
However, there is a significant difference Between the two procedures, let's see:
In the DSAEK se transplants a posterior stromal lenticule along with Descemet's membrane and endothelium. The lenticule is achieved by cutting a layer of the donor's cornea using a microkeratome or, in more modern centers, using a femtosecond laser. For this reason, it is considered an automated technique.
In the DMEKtransplant only the Descemet membrane with the endothelium, which is dissected manually.
Currently, it is difficult to say which technique is better than the other, since we need to continue conducting studies to define which method is the one that yields the best results and greater safety in each case.
However, the DMEK is consideredBy allow transplant only injured layers without touching the rest of the corneal layers, It is a much more revolutionary technique.
