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Descemet membrane endothelial keratoplasty (DMEK) is a method of corneal transplantation that involves the removal of a thin sheet of tissue from the posterior (innermost) side of a person's cornea to replace it with the two posterior (innermost) layers of corneal tissue from a donor's eyeball.
The DMEK procedure is a 'like for like' replacement of the diseased part of the cornea with visual rehabilitation to 20/40 or better in 90% of cases and 20/25 or better in 60% of cases within the first three months. Rejection rates are lower (1%) and visual recovery is faster than any other form of corneal transplantation.
On the left note the adult eye before Pre Descemets Endothelial Keratoplasty surgery . The eye is white and patient cannot see. On the right is same patient after Pre Descemets Endothelial Keratoplasty surgery using a young donors 25 micron corneal tissue . Note the clear eye and patient can see the last line on the vision testing.
During this process, facial muscles might be tightened, while facial fat might be removed or redistributed. Sometimes, a jaw lift is performed in the same surgery by making an incision under the chin and tightening the skin of the jaw and neck. Immediately after the surgery, a drainage tube is used to remove excess fluid from the wound. [23] [24]
Twilight anesthesia is applied to various types of medical procedures and surgeries. It is a popular choice among surgeons and doctors who are performing anything from minor plastic surgeries to dental work, and procedures that do not require extensive operations or long durations in favor of less nausea and a limited recovery period after surgery.
The small incision lenticule extraction (SMILE) procedure was first published in 2011 by Walter Sekundo et al. [7] [10] Various modifications of the procedure have since then been described which aim to reduce the duration of the procedure, reduce the risks of the lenticules being incorrectly cut or make the procedure easier to learn. [8]
While both procedures interact with the epithelium atop the cornea, the PRK procedure removes this entirely, while LASEK brushes the material away for the procedure, before being placed back for healing after laser surgery. [2] The procedure can be used to treat astigmatism, nearsightedness, and farsightedness. [3]
The procedure is also used experimentally to treat tinnitus and vertigo caused by vascular compression on the vestibulocochlear nerve. [2] As the goal of the Jannetta procedure is to relieve (vascular) pressure on the trigeminal nerve, it is a specific type of a nerve decompression surgery.