Fig. 3: Scanning electron microscopy of an explanted Descemet-Endothelium complex of a recipient’s eye with Fuchs Endothelial Corneal Dystrophy, which showed intraoperative splitting during Descemetorhexis.

^#Regular Descemet Membrane interface; ⁺Anterior interface of the split Descemet Membrane; ^*Posterior interface of the split Descemet Membrane. a Overview of a region with intraoperative splitting of the recipient’s Descemet Membrane looking from the Descemet interface side. The panels (b–d) are magnified regions visualized as white rectangles. b Magnification of a border between a split and non-split region of the Descemet-Endothelium complex visualizing the thickness of the split layer, which remains as a remnant on the posterior corneal surface. c Magnification of the split Descemet Membrane layer curling anteriorly, visualizing the three interfaces of intraoperative splitting. The anterior (+) and posterior (*) interface of the split Descemet Membrane seem more irregular than the regular Descemet Membrane interface (#) after Descemetorhexis. d Magnification of the anterior (+) and posterior (*) interface of the split Descemet Membrane showing an irregular surface.