Successful DMEK after intraoperative graft inversion

PURPOSE: Hardiness of a Descemet membrane endothelial keratoplasty (DMEK) graft is not well established. The aim of this study was to report a case of graft survival after intraoperative inversion. METHODS: We describe a case of a 76-year-old man with Fuchs corneal dystrophy who underwent DMEK in the left eye. After deployment of the graft and a 15-minute sulfur hexafluoride gas fill, the graft was noted to be inverted. The graft was then reoriented and properly positioned. RESULTS: Because of progressive graft detachment, rebubble was required at 2 weeks after surgery. At 2 months after surgery, the graft was clear and fully adherent. Specular microscopy revealed 27.9% endothelial cell loss of the donor cornea. CONCLUSIONS: Despite intraoperative inversion, this DMEK graft remained viable without excessive endothelial cell loss.