Surgeons starting to perform Descemet membrane endothelial keratoplasty (DMEK) should be informed about the learning curve and experience of others. OBJECTIVE To document the clinical outcome of standardized "no-touch" DMEK and its complications during the learning curves of experienced surgeons. DESIGN, SETTING, AND PARTICIPANTS Retrospective multicenter study. A total of 431 eyes from 401 patients with Fuchs endothelial dystrophy (68.2%) and bullous keratopathy (31.8%) underwent DMEK performed by 18 surgeons in 11 countries. EXPOSURES Descemet membrane endothelial keratoplasty. MAIN OUTCOMES AND MEASURES Best-corrected visual acuity (BCVA), endothelial cell density, and intraoperative and postoperative complications. RESULTS Of 275 eyes available for BCVA pooled analysis, BCVA improved in 258 eyes (93.8%), remained unchanged in 12 (4.4%), and deteriorated in 5 (1.8%). Two hundred seventeen eyes (78.9%) reached a BCVA of at least 20/40 (Ն0.5), 117 (42.5%) at least 20/25 (Ն0.8), and 61 (22.2%) at least 20/20 (Ն1.0). Eyes with at least 6 months of follow-up (n = 176) reached similar BCVA outcomes. Mean (SD) decrease in endothelial cell density at 6 months was 47% (20%) (n = 133 [P = .02]). Intraoperative complications were rare, including difficulties in inserting, unfolding, or positioning of the graft (1.2%) and intraoperative hemorrhage (0.5%). The main postoperative complication was graft detachment (34.6%); 20.4% underwent a single rebubbling procedure, occasionally requiring a second (2.6%) and a third rebubbling (0.7%), and 17.6% underwent a second keratoplasty.CONCLUSIONS AND RELEVANCE Our multicenter study showed that the standardized no-touch DMEK technique was feasible in most hands. The main challenges for surgeons starting to perform the procedure may be (1) to decide whether graft preparation is outsourced or performed during surgery, (2) to limit the number of graft detachments and secondary procedures, and (3) to obtain organ cultured donor corneal tissue.
Generating particular cutting patterns inside lens tissue can increase the deformation-ability of the crystalline lens. Thus, it might be one possible way to treat presbyopia.
The combination of argon laser coagulation and bevacizumab injections may be a promising tool in treatment of neovascularization in association with corneal transplant surgery. Antivascular endothelial growth factor substances may increasingly play a role in anterior segment surgery in the future.
Combined implantation of an add-on diffractive sulcus IOL and a monofocal capsular bag IOL was safe and effective in improving far and near visual acuity in cataract surgery. Preliminary visual acuity results were similar to those in eyes with a single 1-piece diffractive multifocal IOL.
The creation of gliding planes with a fs laser inside the crystalline lens tissue can change the deformation ability of the lens. This might be an indication for a possible method to treat presbyopia in future.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.