Eyeworld

EW CORNEA 25 even begin to combine the DALK and DMEK techniques, they were faced with a hurdle: The donor cornea had to safely be split in two. Size and thickness of the posterior section of the cornea, which is only 10-15 micrometers thick and very fragile, made this an especially tricky procedure. Splitting the cornea in two "is very difficult to accomplish without damaging the tissue or cre- ating tears," Dr. Cursiefen said. Once the donor cornea was suc- cessfully split, the two procedures were combined, presenting more challenges and chances for compli- cations. DMEK is a fairly new and highly advanced technique and not an option for all cornea surgery cen- ters yet. "At the moment, only the major cornea surgery centers are per- forming DMEK," Dr. Cursiefen said. "But it's becoming increasingly more popular." The risk of complications while using the split-cornea method is also higher than with simply transplant- ing the entire cornea. "If there are complications, we always have the backup of the standard technique," explained Dr. Cursiefen. "So the pa- tient doesn't lose anything. In the worst case scenario, the patient has to undergo a second procedure." On the plus side, however, pa- tients' vision returns at a much faster rate. "With the standard tech- nique, patients get their full visual acuity back after one and a half years," Dr. Cursiefen said. "But with DMEK, these patients have good vi- sual acuity after a few weeks." Currently, the team is making the meeting rounds and presenting the approach to colleagues. They've performed about 100 of these split- cornea operations so far and are con- tinuing to follow up with the patients to assess the long-term vi- sual complications. "Split cornea transplantation re- quires advanced corneal surgical techniques and sophisticated patient logistics, but in the future may be- come a standard approach to save corneal tissue and reduce transplan- tation cost," the researchers wrote. The study, "Split Cornea Trans- plantation for 2 Recipients," was published in Ophthalmology in Au- gust 2010. EW Editors' note: Dr. Cursiefen has no financial interests related to his comments. Contact information Cursiefen: claus.cursiefen@augen.med.uni-erlangen.de FACULTY Alan S. Crandall, MD C. Stephen Foster, MD David R. Hardten, MD Bonnie An Henderson, MD Parag A. Majmudar, MD William L. Rich, III, MD Todd P. Margolis, MD, PhD Roger F. Steinert, MD Karl G. Stonecipher, MD Russell N. Van Gelder, MD PROGRAM HIGHLIGHTS U Riboflavin and UVA Crosslinking – Implications for Refractive and Corneal Surgery U New Therapies for Uveitis U Optimizing Outcomes with IOLs U Cataract Surgery after Corneal Refractive Surgery U The Future of Anti-Infectives U Femtosecond Laser Cataract Surgery U PCR in the Diagnosis of Ocular Infectious Disease U Update on Adhesives U Cataracts – Rock-Hard, Difficult, and Just Plain Nasty... U Keratoplasty – Penetrating and Deep Anterior Lamellar U New for 2011 – Cataract Café U Workshops on EMR, Coding, Work-up of Uveitis, Femtosecond Laser Lab & much more! Come celebrate our 60th Anniversary in the Big Easy! Register now for the early bird rate at www.noao.org For more information call 504-861-2550 or online at www.noao.org The New Orleans Academy of Ophthalmology is accredited by the Accreditation Council of Continuing Medical Education to sponsor continuing medical education for physicians. January 2011

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