Descemet’s membrane endothelial keratoplasty (DMEK) is becoming more popular among corneal surgeons for management of endothelial diseases. The benefits of endothelial keratoplasties include lower rate of rejection, rapid visual recovery, and less surgically induced astigmatism.1 The frequently encountered frustration with DMEK is partial graft detachment in the early postoperative period, which varies in several studies, with one multicentre study reporting the occurrence rate to be as high as 34.6%.2 Typically, partial graft detachments are treated by bringing the patients back to theatre for a re-bubbling procedure. This results in additional costs of theatre utilisation, surgeon time, and staff time.

This paracentesis incision avoids the need for bringing the patient back to the operating theatre, thus reducing the costs and time. This paracentesis can be used up to 2 weeks postoperatively on the slit lamp. The paracentesis is created at 5 o'clock with the assumption that the surgeon is right-handed, and can be modified depending on hand dominance (Figure 1). Using this new paracentesis in all our DMEK patients, we have been successful in 100% avoidance of re-admission to the theatre and cost reductions for re-bubbling procedures.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD