Diane Marinho, M.D., Medical Director for the Eye Bank of Hospital de Clinicas de Porto Alegre in Porto Alegra, Brazil, and recipient of the 2015 Mary Jane O’Neill Fellowship in International Eye Banking, spent a week with us last summer observing and preparing tissue for DSEK and DMEK procedures in our cornea laboratory. We were honored to host Dr. Marinho’s visit and share best practices in eye banking.
Dr. Marinho’s recently published an article highlighting these best practices in the latest issue of the International Journal of Eye Banking: “Transitioning from PK to DMEK in a Public Hospital in Southern Brazil: First Series of 24 Consecutive Cases.”
Endothelial keratoplasty (EK) procedures such as DSEK and DMEK were not currently being performed in Brazil so being able to learn the EK procedures helped to improve treatment of her patients. In her article, Dr. Marinho explains her research and process in applying these procedures in a public hospital in Southern Brazil.
Endothelial keratoplasty (EK) is probably the most exciting development in corneal transplantation since the introduction of monofilament sutures and the operating microscope. Since the advent of penetrating keratoplasty surgery more than 100 years ago, we have recognized the undesirable postoperative consequences of penetrating corneal surgery.1 These adverse sequelae include increased high astigmatism, unpredictable refractive outcomes, prolonged visual rehabilitation and vulnerability to trauma. In cases of corneal edema from endothelial dysfunction, ophthalmologists have conceptualized the theoretical benefits of selectively transplanting only the posterior cornea with healthy endothelium. In 1950, Barraquer proposed performing lamellar transplantation of the posterior cornea in cases of corneal edema. He described a procedure in which he trephined just the posterior central cornea after manually dissecting a rectangular flap similar to that used in Laser-Assisted In Situ Keratomileusis (LASIK). Ultimately a corresponding round lenticule of donor posterior corneal tissue containing healthy endothelium was transplanted into this opening.2 Despite the outstanding idea, the results of this technique were never described and the procedure was forgotten for some decades.
To read the entire article, visit the International Journal of Eye Banking at www.eyebankingjournal.org.