Eversight Services Information 2017 | Page 7

EVERSIGHT SERVICES DMEK: DESCEMET MEMBRANE ENDOTHELIAL KERATOPLASTY DMEK PREPARED TISSUE Eversight Preparation Procedure Tissue is mounted on a vacuum block to perform a 360o partial trephination through the Descemet membrane. Surgical grade trypan blue is then used to stain the tissue for increased visualization. A 360o partial dissection is then performed 1-2mm interior to the trephination score. Next, the Descemet membrane is manually peeled from the stromal bed, leaving a small hinge attached within the trephinated button. After that, the Descemet membrane is gently adhered onto the stromal bed, and the tissue is placed in a corneal viewing chamber containing Optisol GS. Before transport to the surgery location, the tissue undergoes additional specular and slit lamp evaluations. As with any new surgical procedure, Eversight understands the importance of providing flexible options to surgeons as techniques are refined. If you have questions or need alternate preparation options, please contact Eversight. DMEK tissue specification options Button Trephination Single partial trephination: 9.5mm is the standard and largest size offered. Other options: 8.0mm, 8.5mm and 9.0mm. Orientation Markings (Available by surgeon request) Micro Stromal Stamp/ 2mm Punch Combination Before the Descemet membrane is returned to the stromal bed, a 2mm hole is punched through the stroma near the periphery of the trephinated button. After the Descemet membrane is returned to the stroma, the tissue is placed epithelial side up and the micro “S” is stamped onto the stroma through the trephinated hole. The 2mm punch is then replaced into the stromal bed. Fold-Over Micro Stromal Stamp Before the Descemet membrane is returned to the stromal bed, the peripheral edge is folded over onto the rim and the micro “S” stamp is applied to the stromal side of the Descemet membrane. Eversight Support Eversight is committed to ensuring that you are both comfortable and confident as you begin to offer DMEK to your patients. We provide a number of practice opportunities, including wet lab courses, training tissue, supply kits and use of our facility with the assistance of an Eversight processing technician. See opposite side for diagrams. Double partial trephination: 7.25mm, 7.5mm, 7.75mm, and 8.0mm. Hinge Location Our standard DMEK tissue has a peripheral hinge located 1-2mm interior to the trephination line, identified by a scleral marking. Alternatively, a centrally placed 2x2mm hinge is also available by request. Questions? Contact: Lauren Johnson • [email protected] • (800) 247-7250 ext. 2597