Corneal mini implant can spare complete replacement

DMEK procedure often leads to complete recovery
The cornea is, so to speak, the windshield and the front end of the eye. As with any glass or windscreen, sharp vision is only possible when the cornea is clear and transparent. If the "window of the eye" becomes irreversibly affected, for example by genetic or age-related factors or by inflammations and infections, the cornea becomes cloudy and clear vision becomes impossible. Then only a cornea transplant helps.
It is the most common tissue transplantation in humans, with approximately 5,000 procedures per year. Today, there is a new procedure whereby ophthalmic surgeons transplant only a thin layer of the cornea, saving the patient an entire cornea replacement. The so-called DMEK procedure (Descemet Membrane Endothelial Keratoplasty) has fewer side effects, shortens healing and leads to better visual results.

The cornea itself is only about half a millimeter thick. Between a thin outer layer and an extremely thin inner layer lies the load-bearing middle fabric layer. The inner cell layer is equipped with small pumps that carry water from the cornea. Only when these pumps work reliably around the clock and keep the middle "dry" is it possible to see clearly. "Every single layer of the cornea can fall ill", explains Dr. med. Ulrich Jung, medical director of the Artemis Eye Clinic Dillenburg. "While most are well-treated with medications, inner-layer disorders typically result in permanent cloudiness as the pumps fail their service and can not regenerate."

The causes are genetic diseases such as Fuchs's endothelial dystrophy or inflammatory or surgical damage. Patients with a damaged inner layer often complain of decreased facial acuity with lacrimation, light hypersensitivity and sometimes pain. In treatment, the DMEK process is becoming increasingly important today. The cornea is no longer replaced in full thickness, but it is only the ultra-thin inner layer exchanged. This implant is obtained from a donor cornea. The procedure is gentler for the patient as the healing time is extremely short.

"Often, we can reach a vision strength of about 50 percent within a few days after the procedure, which will continue to improve in the weeks following the operation." In the conventional procedure, healing takes up to one and a half years. The procedure is also low in side effects, because there are 15 times less frequent rejection reactions than with complete transplants. Similarly, eliminates the often annoying astigmatism, since now no longer needs to be sewn. "The DMEK procedure usually leads to an almost complete restoration of visual acuity with an excellent long-term prognosis," Dr. Young together.