DMEK Tips and Mishaps: Guard the Gate скачать в хорошем качестве

DMEK Tips and Mishaps: Guard the Gate

The modified Jones tube for DMEK is an excellent injector system. One of the downsides is the fairly large incision required with the current tubes. DMEK grafts behave like fluid and the go toward the path of least resistance. They can be ejected from wounds of any size, but a larger wound is a greater risk. It is important to close the wound with a forcep before coming out with the tube to prevent ejecting the graft. Another way to keep the graft from coming out is to release fluid from a paracentesis and lower the pressure in the anterior chamber that is trying to force the graft out. I should say that in this case, the graft was saved and re-loaded. I have not yet performed cell counts, but the cornea had almost completely deturgesced by post-op week one. I think the best fix for this problem would be to inject through a smaller wound and we are working on developing a Jones tube that will fit through a 2 mm incision.