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Importance of gauging wet lab training outcome to increase safety and enhance the uptake of DMEK surgery

Eye (2024)Cite this article

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Descemet membrane endothelial keratoplasty (DMEK) has emerged as the preeminent intervention for endothelial failure, boasting superior outcomes [1]. Despite its advantages such as reduced cell loss and enhanced visual recovery, DMEK presents challenges due to the intricate handling of grafts, impeding its widespread adoption. Wet lab training has surfaced as an instrumental means for surgeons to master DMEK [2, 3], particularly among young practitioners, thereby enhancing patient outcomes and broadening access to advanced keratoplasty techniques. While the educational efficacy of DMEK wet labs has been previously assessed [2], the performance of novice surgeons with limited graft-handling experience remains unexplored. Given the global prominence and increasing acceptance of DMEK, we conducted an objective appraisal of DMEK wet lab outcomes among attendees of the Royal College of Ophthalmologists, UK, to fill this research gap.

Twenty-four human donor corneal tissues were procured from the NHS Blood and Transplant (NHSBT) eye bank in the UK. Prior to attendance, each participant received instructional materials detailing the surgical procedures involved. DMEK grafts were meticulously prepared utilizing the peeling technique [4] following the initial assessment of corneas, as previously outlined [2]. An impartial observer documented the duration of peeling, incidence of tears, and the time required for loading and unfolding donor grafts for all eight participants. Statistical analyses were conducted using the non-parametric Friedman test with repeated measures, followed by post-hoc Dunns test. Additionally, a two-tailed non-parametric Mann-Whitney test (95% confidence interval) was employed for comparative assessments, with statistical significance set at p < 0.05 using GraphPad Prism Version 7.01.

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Fig. 1: Results of the parameters employed in assessing the efficacy of DMEK wet lab.
Fig. 2: Outcome measures comparing novice and experienced surgeons in evaluating the effectiveness of DMEK wet lab.

Data availability

The data is available upon request.

References

  1. Stuart AJ, Romano V, Virgili G, Shortt AJ. Descemet’s membrane endothelial keratoplasty (DMEK) versus Descemet’s stripping automated endothelial keratoplasty (DSAEK) for corneal endothelial failure. Cochrane Database Syst Rev. 2018;6:CD012097.

    PubMed  Google Scholar 

  2. Parekh M, Wallace AG, Airaldi M, Ruzza A, Ferrari S, Romano V, et al. Performance outcomes from a DMEK peeling and preparation wet lab. BMJ Open Ophthalmol. 2024;9:e001540.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Parekh M, Ruzza A, Rovati M, Tzamalis A, Romano D, Gupta N, et al. DMEK surgical training: an instructional guide on various wet-lab methods. Surv Ophthalmol. 2023;68:1129–52.

    Article  PubMed  Google Scholar 

  4. Parekh M, Borroni D, Ruzza A, Levis HJ, Ferrari S, Ponzin D, et al. A comparative study on different Descemet membrane endothelial keratoplasty graft preparation techniques. Acta Ophthalmol. 2018;96:e718–26.

    Article  PubMed  Google Scholar 

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Acknowledgement

The authors thank Dr. Jim Innes for his support, Dr. Vito Romano and Dr. John Sharp for facilitating the wet lab. The authors also thank all the delegates who attended the DMEK wet lab at Royal College of Ophthalmologists.

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Authors and Affiliations

  1. Moorfields Eye Hospital NHS Foundation trust, London, UK

    Tina Khanam

  2. Spire St. Anthony’s, London, UK

    Tina Khanam

  3. Centre For Sight, London, UK

    Tina Khanam

  4. My-iClinic, London, UK

    Tina Khanam

  5. The Royal College of Ophthalmologists, London, UK

    Tina Khanam

  6. Institute of Ophthalmology, University College London, London, UK

    Mohit Parekh

Authors
  1. Tina Khanam
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  2. Mohit Parekh
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Contributions

Data acquisition, study design, performing, writing and reviewing the draft: TK and study design, data analysis, writing and reviewing the draft: MP.

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Correspondence to Tina Khanam.

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The authors declare no competing interests.

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Khanam, T., Parekh, M. Importance of gauging wet lab training outcome to increase safety and enhance the uptake of DMEK surgery. Eye (2024). https://doi.org/10.1038/s41433-024-03144-8

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