Clinical ophthalmology
A Novel Microbubble Air Injection System for Controlled Graft Fixation in DMEK Surgery
By Tsai TY, Kuo YK and Chen SY.
Abstract
Purpose
To describe a novel, low-cost microbubble air injection system using a customized 3-French nasogastric tube for precise volume control and stable graft fixation during Descemet membrane endothelial keratoplasty (DMEK).
Design
Retrospective, single-surgeon observational study.
Methods
A total of 80 eyes of 80 patients who underwent DMEK surgery between 2021 and 2025 were included. All procedures were performed by a single corneal specialist with more than 15 years of corneal surgical experience and approximately 5 years of DMEK experience. The system consisted of a standard 27-gauge anterior-chamber cannula connected to a short segment of 3-French nasogastric tubing. Technical success was defined as generation and intracameral delivery of a microbubble sufficient to complete the intended graft-positioning/fixation maneuver without conversion to conventional syringe-based air injection. Device-related intraoperative complications, conversion, rebubbling, elevated intraocular pressure (IOP), primary graft failure, graft rejection, best-corrected visual acuity (BCVA), central corneal thickness (CCT), and postoperative endothelial cell density (ECD) were reviewed.
