Fig. 5: Step-by-step procedure of DMEK.
From: Advancements in bioengineering for descemet membrane endothelial keratoplasty (DMEK)
a Circular rhexis of the peripheral Descemet membrane and staining with trypan blue followed by lifting of the Descemet edge. b Separation of the Descemet membrane using two forceps. c Trephination with an 8-mm trephine. d, e Placement of graft markings for intraoperative orientation using a 1 mm trephine (green arrows). f Peeling off the graft. g, h Loading the graft into the injector cartridge. i Making incisions. j Spreading the iridotomy with vitreous scissors. k Descemetorhexis. l Insertion of the graft. m Unfurling of the graft. n Verification of graft markings (green arrows). o Injection of the air bubble. p Filling with 20% sulfur hexafluoride (SF6) gas. (With the kind using permission of Prof. Dr. med. Claus Cursiefen and Prof. Dr. med. Björn Bachmann, University Hospital of Cologne, Department of Ophthalmology, Cologne, Germany).
