Non-Descemet Stripping Descemet Membrane Endothelial Keratoplasty

Purpose: To report a case of non-Descemet stripping Descemet membrane endothelial keratoplasty (nDMEK) in a patient with pseudophakic bullous keratopathy. Methods: A 70-year-old man underwent an nDMEK in his right eye, which suffered from pseudophakic bullous keratopathy after a complicated cataract surgery was performed. Under local anesthesia, an 8-mm sized round Descemet membrane and endothelial cell graft (DMEK graft), harvested from an 85-year-old male donor cornea, were transplanted without stripping the recipient's Descemet membrane. The patient was examined at 1 week, 2 weeks, 3 weeks, 4 weeks, 2 months, 4 months, and 6 months after the surgery took place. Optical coherence tomography, Scheimpflug imaging (Pentacam, Oculus), and specular microscopy were performed. Results: Graft detachment was observed at 1 and 2 weeks after the surgery, but this was successfully resolved with C3F8 gas tamponade in the anterior chamber. Thereafter, no graft detachment was observed, and the cornea remained clear 6 months after the surgery. The best-spectacle corrected visual acuity was improved from 20/100 to 20/25, and central corneal pachymetry was improved from 713 to 570 µm. No ocular complication was detected at the final visit. Conclusions: An nDMEK was successfully performed in a patient with pseudophakic bullous keratopathy and resulted in a good visual outcome.