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Corneal transplantation is the most frequently performed and most successful organ transplantion in medicine. Each layer of the cornea can develop its own disease. For example, the inner layer of the cornea (endothelium) can become cloudy after cataract surgery or in the case of Fuchs' corneal endothelial dystrophy. The pathological inner layer – consisting of the Descement membrane and endothelium – is replaced within an operation called DMEK (Descemet Membrane Endothelial Keratoplasty). During the process the layer is introduced into the front chamber of the patient’s eye in a coiled status by means of a so-called DMEK-shooter. A problem is that the Descemet membrane has the tendency to automatically wind itself up to form a single-axis winding. The membrane must therefore be unwound manually by the surgeon after insertion into the front chamber of the eye, partly with the aid of further instruments and/or by air bubble or pressure on the cornea. This surgical technique is time-consuming, can damage the graft and is stressful for the eye.
Keywords: Hornhauttransplantation, Descemet Membran, Innenschichttransplantation der Hornhaut (hintere lamelläre oder endotheliale Transplantation), DMEK/DSAEK, Transplantat, DMEK-Röhrchen, Rörchen, Chirurgie, Operationstechnik, Augenheilkunde, Hornhauttrübung, corneal transplantation, Descemet membrane, Descemet Membrane Endothelial Keratoplasty (DMEK), descemet stripping automated endothelial keratoplasty (DSAEK), transplant, DMEK-shooter, tube, surgery, surgical technique ophthalmology, corneal clouding
Ophthalmologists at the University Hospital of Cologne have developed a DMEK-shooter that significantly makes the operation easier by unrolling the membrane in the eye faster, safer and more standardised already during the process of implantation. Tubes used so far have a cylindrical form with a round profile (see figure). The inventive shooter is characterised by an oval profile and a novel shape of the inner architecture. This shape allows uncoiling of the Descemet Membrane already during release from the shooter. Thereby, the number of subsequent surgical steps and the likelihood of complications is reduced and consequently the success rate of this surgical method is increased.
Operation more rapid, safer, more standardised and simpler:
- better and faster uncoiling of the transplanted Descemet membrane
- reduced risk of complications
- increased success rate
- reduced duration of surgery
In Germany alone every year 6,000 donor corneas are transplanted. Approximately 185,000 transplantations were performed worldwide in 2012. The number of DMEKs in Germany increased 8-fold from 2011 to 2016. The invention is offered for licensing and further co development in collaboration with the researchers.
A transparent and Luer-Lock compatible prototype has been produced by 3D-printing and successfully tested with human Descemet´s membranes. In case of interest we will be pleased to inform you about the patent status.