Investigation of cornea graft failure following DMEK surgery

One option for corneal transplants is DMEK (Descemet Membrane Endothelial Keratoplasty). The procedure is outlined here. As described, once the replacement cornea is unrolled and positioned in the anterior chamber of the eye, SF6 or Air is injected below the cornea graft to push it up to the graft site. SF6 or Air is then left in the chamber until it is naturally replaced by the aqueous fluid of the eye. This takes a few days.

During the recovery period the patient is instructed to lie down for longer periods especially in the immediate period after surgery. Following this period the patient is allowed to move freely. It is known that some grafts peel away from the graft site, and the surgery must be repeated.

FTS Engineering Answers is working with Moorfields Eye Hospital to investigate the problem using CFD.

We are helping to show that the presence of both liquid and gas in the anterior chamber during the motion, as a patient moves from horizontal to vertical, may causes a force that effectively drags the cornea graft off the graft site. Removing the air/gas reduces or eliminates the force. This discovery may potentially lead to a change of surgical procedure.

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