Novel Technique for Donor Insertion and Unfolding in Desceme
A Study was conducted to describe a novel technique for insertion and unfolding of donor Descemet membrane (DM) scroll during DM endothelial keratoplasty (DMEK).

DMEK was performed in 20 eyes. The donor DM scroll was loaded into a glass injector, and the fluid column was manipulated to achieve a double scroll configuration. After performing DM stripping and inferior iridectomy, an anterior chamber (AC) maintainer was placed in position. The glass injector was inserted into the AC and the tip rotated to ensure correct orientation of the DM scroll. The outcomes of this surgical technique were analyzed.

--Donor DM insertion and unfolding were performed without any complications in all eyes.

--Double scroll configuration of donor DM in the injector could be achieved in 17 of 20 eyes.

--A controlled delivery, maintaining correct scroll orientation, was possible in all eyes. Intraoperative duration from insertion to unfolding was 252.7 ± 45.4 seconds.

--A clear cornea was achieved in all eyes, with 75% of eyes (15/20) achieving corrected distance visual acuity of 20/20 or better, at average follow-up duration of 13.3 ± 1.3 months.

--Endothelial cell loss at 6 months follow-up was noted to be 16.7%. Partial donor detachment was noted in 2 eyes (10%), which resolved spontaneously.

This unique donor DM insertion approach allows for facile donor insertion and unfolding, simplifying the DMEK procedure.