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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.
Pre Descemet's endothelial keratoplasty (PDEK) is a kind of endothelial keratoplasty, where the pre descemet's layer (PDL) along with descemet's membrane (DM) and endothelium is transplanted. [1] Conventionally in a corneal transplantation , doctors use a whole cornea or parts of the five layers of the cornea to perform correction surgeries.
Corneal transplantation, also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). When the entire cornea is replaced it is known as penetrating keratoplasty and when only part of the cornea is replaced it is known as lamellar keratoplasty.
Historically, penetrating keratoplasty, or full thickness corneal transplantation, was the treatment of choice for irreversible endothelial failure. More recently, new corneal transplant techniques have been developed to enable more selective replacement of the diseased corneal endothelium.
Most cases of PPMD are asymptomatic, and these cases generally do not require treatment. PPMD patients with bilateral, corneal opacities that can affect vision, descemet’s membrane endothelial keratoplasty or penetrating keratoplasty are the treatments of choice to improve vision and to avoid amblyopia.
Descemet's membrane (or the Descemet membrane) is the basement membrane that lies between the corneal proper substance, also called stroma, and the endothelial layer of the cornea. It is composed of different kinds of collagen (Type IV and VIII) [1] than the stroma. The endothelial layer is located at the posterior of the cornea.
This piece of equipment is used all around the world to cut the cornea flap. The microkeratome is also used in Descemet's stripping automated endothelial keratoplasty (DSAEK), where it is used to slice a thin layer from the back of the donor cornea, which is then transplanted into the posterior cornea of the recipient. [2]
When endothelial cell counts drop too low, the pump starts failing to function and fluid moves anterior into the stroma and epithelium. The excess fluid precipitates swelling of the cornea. As fluid accumulates between the basal epithelium cells, blister like formations form (bullae) and they undergo painful ruptures releasing their fluid ...