OCT 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/194331

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October 2013 remain drawbacks. In an attempt to overcome these limitations, pioneering corneal surgeons have invented the donor preparation surgical procedure to minimize the remaining stromal tissue. The donor Descemet's membrane is scored and trephined from the endothelial side without any donor corneal stroma. Also, there is no need for an artificial anterior chamber or a microkeratome in the donor tissue preparation. This DMEK procedure can accelerate the recovery and increase the chance of obtaining 20/20 vision postoperatively. Moreover, the rate of rejection with DSAEK may be successfully reduced by minimizing antigen exposure. However, DMEK is a more challenging procedure than established DSAEK surgery. DMEK has the potential of inflicting damage to the donor endothelium and Descemet's membrane during the surgical preparation and introduction into the anterior chamber. Moreover, unfolding procedure and re-attachment techniques are more challenging. The pros and cons of each advanced posterior lamellar replacement procedure have been proven. However, apart from the results of each procedure, an important factor in selecting particular surgical technique is the experience of the operating surgeon. Even though the surgical outcome of DMEK is superior in many aspects, the surgeon with lack of surgical experience and limited skills may elect not to choose DMEK. Too aggressive trial of a difficult procedure may induce significant added cost to this surgery. In the near future, better surgical techniques and instruments will be introduced to facilitate DMEK procedure without jeopardizing the surgical outcome. Until then, DSAEK will account for a great part of posterior lamellar procedures. EW Editors' note: Dr. Young acknowledged the assistance of Dr. Vishal Jhanji in writing his comments. Dr. Young has no financial interests related to this article. Dr. Kim has no financial interests related to this article. Contact information Young: Prof.A.Young@gmail.com Kim: tikim@yuhs.ac EW International 95 The Hamilton Eye Institute at The University of Tennessee Health Science Center Memphis, TN invites you to a celebration of T H E 1 2 TH S i r H a r o l d R i d l e y Distinguished Visiting Professorship for Creativity & Innovation in Medicine and Ophthalmology honoring "Los Tres Amigos" Paul Honan, MD ~ Tom Mazzocco, MD ~ Richard Kratz, MD Thursday, November 21, 2013 Reception 6:00 pm ~ Lecture 7:00 pm 930 Madison Avenue, Freeman Auditorium, Third Floor Memphis, Tennessee webcast available at http://www.eye.uthsc.edu/ridley RSVP by November 14, 2013 ~ Debra Trapp (901) 448-5492 or dtrapp@uthsc.edu These distinguished senior ophthalmologists have been leaders in the revolution in modern cataract surgery in America and beyond. Over the decades, they have continued in their teaching, innovation, and contributions. They have not neglected their duties as faithful students and observers with their constant, regular attendance of and presentation in major medical and ophthalmic meetings here and abroad. They are so often seen walking or collaborating together that they have earned the respect and affectionate moniker of "Los Tres Amigos." They have never quit. In recent years, their studies and convictions have led them to tag "chronic inflammation" to be an integral part of the disease process presenting in medicine and ophthalmology.

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