Unfolding Techniques for the DMEK Graft

  • Ester Fernández
  • Jack Parker
  • Isabel Dapena
  • Lamis Baydoun
  • Vasilios S. Liarakos
  • Gerrit R. J. Melles


In Descemet membrane endothelial keratoplasty (DMEK), graft unfolding is often perceived as the most difficult step and the most challenging to learn [1–3]. Of course, the best way to learn anything is by practice, and for DMEK surgery, there exist both an animal eye model [4] and a method for simulating the operation using an artificial anterior chamber (which is how we teach graft unfolding at our wet-lab courses). Beginning surgeons may also be comforted to know that most clinical outcomes during the “learning curve” of the operation approximate those obtained by more experienced hands [5–7].


Anterior Chamber Endothelial Cell Density Double Roll Single Roll Shallow Anterior Chamber 
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Copyright information

© Springer India 2016

Authors and Affiliations

  • Ester Fernández
    • 1
    • 2
  • Jack Parker
    • 3
    • 1
  • Isabel Dapena
    • 1
    • 2
  • Lamis Baydoun
    • 1
    • 2
  • Vasilios S. Liarakos
    • 1
    • 2
  • Gerrit R. J. Melles
    • 1
    • 2
    • 4
  1. 1.Netherlands Institute for Innovative Ocular SurgeryRotterdamThe Netherlands
  2. 2.Melles Cornea Clinic RotterdamRotterdamThe Netherlands
  3. 3.UAB Callahan Eye HospitalBirminghamUSA
  4. 4.Amnitrans EyeBank RotterdamRotterdamThe Netherlands

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