The evolution of DMEK: Understanding the shift
Endothelium-in DMEK: A complex yet promising approach
The webinar delved into the intricacies of Endothelium-in DMEK, with Dr. Sales sharing surgical videos demonstrating how the tissue, when pulled through, naturally unfurls within the anterior chamber. He contrasted this with the conventional Endothelium-out, tap-technique DMEK, where surgeons manually tap the cornea to unfold the graft.
While the technique shows promise, it is not without challenges. Dr. Sales described the procedure as “ergonomically complex” due to the intricate hand positioning and coordination required. He emphasized that mastering Endothelium-out DMEK is essential before incorporating Endothelium-in DMEK into surgical practice.
Case selection and surgical considerations
Dr. Sales outlined the types of cases best suited for Endothelium-in DMEK, including post-vitrectomy eyes, anterior chamber intraocular lenses (ACIOLs), and eyes with nearly opaque corneas. He also highlighted situations where Endothelium-out DMEK remains the preferred choice, such as cases involving non-vitrectomized eyes with normal anterior chamber depth.
The discussion also touched on tissue handling, with Dr. Sales recommending a collaborative approach with eye banks to ensure proper graft preparation.
Looking ahead: Efficiency and outcomes
Stay tuned for more insights
Eversight Academy’s webinar series continues in May with a session featuring Dr. Sophie Deng from the UCLA Jules Stein Eye Institute, discussing the management of limbal stem cell deficiency. Stay connected for more educational opportunities as we explore the latest advancements in corneal care.
Missed the webinar? Keep an eye on your inbox for future sessions and join us as we continue advancing the gift of sight through innovation and collaboration.
Eversight's free webinars are a great way for you to connect, learn and train digitally with leading ophthalmologists and researchers from around the world. We invite you to RSVP for scheduled webinars and browse our recording library.
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About the author
Michael Szkarlat, Partner Development Director
Michael has been with Eversight since 2016 and has recently worked to develop Eversight's educational wet lab programs for EK surgery and a standardized protocol for DALK practice in a wet lab setting. His eye banking experience is rooted in the preparation of corneal grafts and spent nearly five years as Eversight’s Medical Director designee in charge of training clinical team members to prepare corneal tissue for DMEK and DSAEK surgery. In his time at Eversight, Michael has presented at scientific conferences, been involved in clinical research and developed innovations in tissue processing. He was named an IAPB Eye Heath Hero in the innovations category. Michael is passionate about community-based eye banking and honoring the precious gift that is donation. When not at work, he enjoys traveling with his wife and baking artisan sourdough bread.
