Happy New Year! I hope everyone has a wonderful, healthy, happy and prosperous 2016.
After a short break over the holidays, where my wife and I spent some time relaxing and surfing in McLaren Vale, I’m quickly getting back into the swing of things. As a Staff Specialist at the Royal Victorian Eye and Ear Hospital (RVEEH) in the Cornea Unit, I spent the first full week of the year on call and filling in for other ophthalmologists who are still on holiday. In less than 2 weeks, I have already done 50 cataract surgeries and several cornea operations including endothelial transplants. It looks like it’s going to be a busy and productive year, with plenty to look forward to.
I’m particularly looking forward to Melbourne hosting the 2016 Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Cornea Society Meeting. It’s shaping up to be a great meeting with some excellent international guest speakers attending. I have been asked to speak at this meeting about my experience with Descemet’s Membrane Endothelial Keratoplasty (DMEK), the newest technique for replacing unhealthy endothelium. This procedure is indicated in patients with a damaged endothelium, that causes fluid to build up in the cornea. Some of these conditions include Fuchs’ corneal dystrophy, pseudophakic bullous keratopathy (PBK), and posterior polymorphous dystrophy. I look forward to sharing my ideas and experiences with other ophthalmologists and conference attendees. We are sure to learn a lot from each other.
Over the last few months, I have spent several sessions working with our fellows at RVEEH and with the eye bank technicians at Lions Eye Donation Service to improve the current DMEK technique. Through our work, we hope to provide tissue to cornea specialists that is pre-prepared by the eye bank technicians and marked with a stamp to enable the surgeon to easily tell the orientation of the tissue after it is transplanted. This should reduce the likelihood of having a tissue transplanted in the wrong orientation and improve the outcomes of the DMEK surgical technique. We have also been working on a technique to allow DMEK surgery to be completed in eyes with anterior chamber intraocular lenses (ACIOLs) and in eyes that have had a prior vitrectomy surgery. Currently, these cases are very challenging and most commonly managed with a Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK).
The difference between these operations is described in cornea section of the website. Basically, DMEK tissue includes 2 layers of the cornea: the endothelium and Descemet’s membrane. DSAEK tissue is a little bit thicker as it includes 3 layers of the cornea: the endothelium, Descemet’s membrane, and a small portion of the stroma.