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More efficient use of donor corneal tissue with Descemet membrane endothelial keratoplasty (DMEK): two lamellar keratoplasty procedures with one donor cornea
  1. J T Lie1,2,
  2. E A Groeneveld-van Beek1,2,
  3. L Ham1,3,
  4. J van der Wees1,2,
  5. G R J Melles1,2,3
  1. 1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
  2. 2Amnitrans EyeBank, Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
  3. 3Melles Cornea Clinic, Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
  1. Correspondence to Gerrit R J Melles, Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; melles{at}niioc.nl

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Since 1998, we have published several techniques for endothelial keratoplasty, popularised as deep lamellar endothelial keratoplasty (DLEK), Descemet stripping (automated) endothelial keratoplasty (DSEK/DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).1–3 All of these techniques potentially provide the possibility of using a single donor cornea for more than one recipient: because only the posterior corneal layers are used in endothelial keratoplasty, the remaining anterior cornea may potentially be used in an anterior lamellar keratoplasty procedure.

With the advent of DMEK, for which Descemet membrane with its endothelium is stripped from a donor corneo-scleral rim to subsequently become transplanted, the complete donor stroma is left intact for other different transplantation purposes,4 including a “full-stromal-thickness” deep anterior lamellar keratoplasty (DALK). However, the preparation of thin Descemet grafts may …

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