Week 5: DMEK Surgeries

This week I worked on my project some more and got to shadow Dr. Sales, who is an ophthalmologist, for a whole day in the operating room. 

Five of the eight operations that I watched this week were Descemet's Membrane Endothelial Keratoplasty (DMEK) surgeries. I watched one DMEK procedure during my first week here, and I was excited to see more of this type of surgery. DMEK is a partial thickness cornea transplant procedure that involves removing the diseased Descemet's membrane and replacing it with one from a donor. There are different kinds of cornea transplant procedures, but this one is unique in that only the donor's Descemet's membrane is used and none of their stroma tissue. Once the tissue is placed in the eye, Dr. Sales gently taps on the cornea to get it to unfold and then an air bubble is used to keep it in place.  DMEK surgeries are relatively short like cataract surgeries in that they only take about 30 minutes to complete but they are more complex in that the insertion of the tissue can be a lot harder to place correctly unlike the lens in a cataract surgery. I also saw several other types of surgeries that day as well. There was a cataract surgery and another surgery where Dr. Sales separated the iris from the lens in another patient. Usually, during eye surgeries, the patient is not under general anesthesia because it can be dangerous if they wake up and get startled. So instead they are given some medication to relax. During that patient's cataract surgery, they got startled awake and moved when they were still operating which led to their lens being stuck onto their iris. Below is a picture of the structures of the eye including the cornea, lens, and Descemet's membrane. 

I am shocked that we have already spent five weeks in the city. I haven't been getting much sleep since there is so much to do in the city, but I didn't expect my time here to go by quite this fast. However, I am excited that this is not yet the end, and there is still time to continue to explore the sites that I haven't seen yet in Manhattan and to learn more from the clinicians as well.

Picture: NIH