Department of Ophthalmology, University College of Medical Sciences and GTB Hospital, New Delhi, India.
Cornea Clinic, Apollo Hospitals, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2022 Aug;70(8):2956-2961. doi: 10.4103/ijo.IJO_244_22.
This study aims to assess the preferred surgical technique of Descemet membrane endothelial keratoplasty (DMEK) among corneal surgeons in India, and barriers in performing DMEK surgeries amongst the non-DMEK surgeons.
An online, questionnaire-based, cross-sectional survey was conducted among members of the Cornea Society of India (CSI) (n = 500). Responses on their surgical experience, preferred technique, complications, and outcome of DMEK were collected and analyzed. Barriers in performing DMEK surgeries were assessed amongst the non-DMEK surgeons.
A total of 100 responses were obtained and response rate for the survey was 20%. DMEK was performed by 55% of the participants of whom only 40% had formal training in this technique. Surgical video-based learning was the most often used self-training method for others. Lack of training was the most common reason for not performing DMEK by the non-DMEK surgeons. Descemet stripping endothelial keratoplasty (DSEK) was the most common endothelial keratoplasty (EK) performed by both DMEK and non-DMEK surgeons. High volume (>50 cases) DMEK surgeries were reported by limited surgeons (n = 6). Nearly all the DMEK surgeons prepared the donor tissue by themselves on the day of the surgery, and majority felt that unrolling the graft in the anterior chamber was the most difficult surgical step. Nearly 80% of the DMEK surgeons were more comfortable with DSEK or Descemet stripping automated endothelial keratoplasty (DSAEK) when compared to DMEK.
DMEK practice in India needs improvement with increased accessibility to DMEK training programs, wet lab facilities, and better support from eye banks.
本研究旨在评估印度角膜外科医生对角膜内皮移植术（DMEK）的首选手术技术，以及非 DMEK 外科医生在进行 DMEK 手术方面的障碍。
对印度角膜协会（CSI）的成员（n=500）进行了一项在线、基于问卷的横断面调查。收集并分析了他们在 DMEK 手术方面的手术经验、首选技术、并发症和结果。评估了非 DMEK 外科医生在进行 DMEK 手术方面的障碍。
共获得 100 份回复，调查回复率为 20%。55%的参与者进行了 DMEK，其中只有 40%接受过该技术的正规培训。对于其他人来说，基于手术视频的学习是最常用的自我培训方法。缺乏培训是非 DMEK 外科医生不进行 DMEK 的最常见原因。DMEK 和非 DMEK 外科医生最常进行的内皮角膜移植术（EK）是撕囊式内皮角膜移植术（DSEK）。只有有限的外科医生（n=6）报告了高容量（>50 例）的 DMEK 手术。几乎所有的 DMEK 外科医生都在手术当天自己准备供体组织，大多数人认为在前房展开移植物是最困难的手术步骤。与 DMEK 相比，近 80%的 DMEK 外科医生对 DSEK 或撕囊自动化内皮角膜移植术（DSAEK）更为熟悉。
与 DMEK 培训计划、湿实验室设施和眼库更好的支持相比，印度的 DMEK 实践需要改进。
