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Purpose: To analyze the functional and anatomic outcomes of management of Descemet membrane detachment after phacoemulsification using a protocol based on the detachment's height, extent, and chord length and its relation to the pupil., Setting: Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India., Design: Prospective comparative case series., Methods: Eyes with post-phacoemulsification Descemet membrane detachment were managed surgically or medically based on the detachment's height, extent, length (chord), and relation to the pupil (HELP protocol). Central corneal thickness (CCT), chord length, and detachment height were determined by anterior segment optical coherence tomography (AS-OCT) (Visante)., Results: Of 161 eyes, 96 were treated surgically (Group 1) and 65 medically (Group 2). The mean length and mean height of Descemet membrane detachment were 2.4 mm ± 1.4 (SD) and 266 ± 189.8 μm, respectively, in Group 1 and 1.03 ± 0.4 mm and 153.3 ± 60.8 μm, respectively, in Group 2. The complete reattachment rate was 95.8% in Group 1 and 96.9% in Group 2. The corrected distance visual acuity (CDVA) was 20/40 or better in 83.3% of eyes in Group 1 and 92.3% of eyes in Group 2. No eye lost CDVA as a result of a Descemet membrane scar in the central 5.0 mm of the cornea. The AS-OCT allowed visualization of the detachment in all eyes with a CCT of more than 800 μm. There was no difference in the final CDVA between Group 1 and Group 2., Conclusions: The AS-OCT-based algorithm was effective for managing post-surgical Descemet membrane detachment in eyes with dense corneal edema. Early surgical intervention for detachments in the central cornea can reduce scarring-induced visual loss., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

We present a surgical technique for evacuating an intracorneal pre-Descemet hematoma that occurred during a canaloplasty procedure. The technique allows both evacuation of the hematoma outside the anterior chamber and preservation of the intact Descemet membrane, and it can be performed within the primary procedure. Intraoperative pre-Descemet hematoma is reported to be a relatively rare complication of canaloplasty; however, to hasten visual recovery and to avoid potentially sight-threatening complications, surgeons should be aware of this possible complication and be prepared to resolve it as early as possible, even within the canaloplasty procedure., (Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Unlabelled: Compromised visibility is problematic with Descemet membrane endothelial keratoplasty (DMEK), especially in the presence of corneal edema. Visibility may be enhanced by dehydrating the cornea preoperatively and by debriding the epithelium, staining the graft, and using a handheld slitlamp during surgery. Because the DMEK graft is transparent, thin, and flimsy, it is difficult to confirm the position, orientation, and morphology even with a clearer cornea. We describe a technique (endoilluminator-assisted DMEK) for identifying graft orientation and enhancing 3-dimensional depth perception within the anterior chamber of the graft. The technique uses oblique light from the endoilluminator for better visualization. Light reflexes from graft folds and edges aid further. This technique has the advantages of being able to visualize the entire graft even through hazy cornea, providing the surgeon with better comprehension of graft dynamics, morphology, orientation, and positioning. This leads to easier and faster surgery, potentially decreasing graft damage due to excessive fluidics and unnecessary manipulation., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate bimanual microincision cataract surgery (MICS) clear corneal incision (CCI) architectural features over the long-term using anterior segment optical coherence tomography (AS-OCT)., Design: Case series., Setting: Institute of Ophthalmology, University of Modena, Modena, Italy., Methods: Patients who had uneventful bimanual MICS in the previous 2 to 16 months were examined using AS-OCT. Images were used to measure corneal thickness, incision length, incision angle, incidence of epithelial or endothelial gaping, misalignment, Descemet membrane detachment, and posterior wound retraction., Results: Fifty-two eyes (33 patients) were enrolled. Mean incision length and incision angle were, respectively, 1427.91 μm and 31.19 degrees for the right hand, 1440.63 μm and 31.54 degrees for the left hand, 1474.13 μm and 31.27 degrees for temporal incisions, and 1394.41 μm and 31.46 degrees for nasal CCIs. Posterior wound retraction was the only architectural feature found. Its prevalence was 7.10% at 2 to 3 months, 31.8% at 4 to 11 months, and 33.3% at 12 months. Fifty-three percent of posterior wound retractions were in 1.8 mm CCIs and 47% in 1.4 mm CCIs., Conclusions: Bimanual MICS was not related to particular morphologic features of CCIs. The enlargement of 1 incision or construction of the incision with the dominant or the nondominant hand did not affect long-term wound architecture. Posterior wound retraction was the only architectural feature; however, its prevalence seems substantially lower than with other surgical techniques., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To analyze the outcomes of post-cataract surgery descemetopexy for Descemet membrane detachment using intracameral air injection., Setting: Cornea Department, LV Prasad Eye Institute, Hyderabad, India., Design: Interventional case series., Methods: The clinical data of patients who had descemetopexy from August 2010 to February 2011 for Descemet membrane detachment after cataract surgery using intracameral (100%) air injection were reviewed after institutional review board and ethics committee approval was obtained., Results: Of the 14 patients, 9 had manual small-incision cataract surgery using the Blumenthal and Moisseiev technique, 4 had phacoemulsification, and 1 had combined phacoemulsification with trabeculectomy. The mean duration between cataract surgery and descemetopexy was 19.5 days (range 2 to 49 days). Successful reattachment of Descemet membrane and resolution of corneal edema occurred in all except 1 patient. Two patients had elevated intraocular pressure 1 day postoperatively due to appositional angle closure in 1 and pupillary block in the other. Of the 13 patients with successful Descemet membrane reattachment, the corrected distance visual acuity was 20/40 or better in 11 cases, 20/80 in 1 case, and 20/160 in 1 case. Three of the 13 patients had comorbidity factors affecting vision., Conclusion: Air descemetopexy was a safe option in the management of Descemet detachment after cataract surgery., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare incision integrity after clear corneal microcoaxial phacoemulsification using longitudinal and torsional ultrasound (US)., Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India., Design: Prospective randomized experimental clinical trial., Methods: Part 1 comprised an experimental study of rabbit eyes. Group 1 received longitudinal US. Group 2 received torsional US. The right eye of each rabbit served as a control. Samples were processed for histomorphology and collagen I denaturation by immunofluorescence. Part 2 comprised a clinical trial of patients. Group 1 received torsional US. Group 2 received longitudinal US. At the end of surgery, trypan blue 0.0125% was instilled. After 2 minutes, 0.1 mL of aqueous was aspirated and its optical density measured., Results: In part 1, incision histomorphology was comparable in both modalities. Collagen denaturation tests (immunofluorescence, dot blot analysis) showed no irregularity in collagen arrangement in either group. In Group 2, Descemet membrane was detached and endothelial cells were minimal at the roof of the incision. In part 2, trypan blue ingress into the anterior chamber was significantly greater in Group 1 than in Group 2 (mean 3.40 + 0.6 log units versus and 3.77 + 0.82 log units) (P<.007)., Conclusions: Incision histomorphology in the torsional group showed minimal Descemet membrane detachment and minimal endothelial cell loss at the roof of the incision. Minimal ingress of trypan blue into the anterior chamber was observed with torsional US, indicating better wound integrity than with longitudinal US., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the long-term wound-healing changes in clear corneal cataract incisions using Fourier-domain optical coherence tomography (OCT)., Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA., Design: Case series., Methods: Multiple OCT images were obtained in consecutive eyes that had phacoemulsification 1 day to 180 months previously. The incision midpoint was measured with OCT. The presence of Descemet membrane detachment, posterior wound gape, and posterior wound retraction was assessed. The depth of wound retraction along the incision and the radial length of the incision were measured. The percentage of wound retraction relative to radial incision length was calculated., Results: Descemet membrane detachment was present in 37.1% of eyes 1 day postoperatively and in 4.5% of eyes at 1 to 3 months (P=.005); it was absent after 3 months. Posterior wound gape appeared in 85.7% of eyes at 1 day and in 31.8% at 1 to 3 months (P<.001); it was absent after 3 months. Posterior wound retraction appeared in 33.3% of eyes at 2 to 3 weeks, in 75.0% at 1 to 3 years, and in 90.5% after 3 years (P<.001). The mean wound retraction was 120 μm ± 46 (SD) (range 24 to 225 μm), which was 7.5% ± 3.1% (range 2.0% to 13.4%) of the radial incision length., Conclusion: Descemet membrane detachment and posterior wound gape appeared in the early postoperative period and persisted for up to 3 months, whereas posterior wound retraction developed later and was present in more than 90% of eyes after 3 years, indicating long-term wound remodeling., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To use Fourier-domain anterior segment optical coherence tomography (AS-OCT)) to evaluate the main clear corneal incisions (CCIs) in microcoaxial and biaxial cataract surgery, the effects of incision enlargement, and the probable reasons for problematic healing., Setting: Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey., Design: Cohort study., Methods: Eyes that had microcoaxial cataract surgery through a 1.8 mm CCI or biaxial cataract surgery through a 1.2 to 1.4 mm trapezoidal CCI were divided into 2 equal subgroups based on incision enlargement. All surgeries were completed by stromal hydration. Incisions were evaluated 1, 8, and 30 days postoperatively., Results: The CCIs in the microcoaxial group were longer, thinner, and more slanted than those in the biaxial group, with no statistical difference. The microcoaxial incisions had significantly more arcuate configuration at 1 day (P=.003); however, the configuration became linear in the following days in both groups. The endothelial gap rates were less and Descemet membrane detachment rates greater than reported in the literature. In eyes with enlarged CCIs, the endothelial gap rate was higher in the microcoaxial group and the Descemet membrane detachment rate was higher in the biaxial group (both P=.05). At 1 day, the intraocular pressure (IOP) was significantly lower in Descemet membrane detachment and endothelial gap cases (P=.006 and P<.001, respectively)., Conclusions: Although closure was reliable in both groups, the microcoaxial group had slightly fewer undesirable effects on the incision site. Low postoperative IOP seemed to be a significant factor in problematic healing., (Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

We report the case of a 68-year-old man who developed bilateral Descemet membrane detachment (DMD) 4 weeks after successful cataract surgery and discuss the possible role of an underlying predisposition to DMD. Surgical intervention with gas injection in the anterior chamber resulted in excellent visual acuity restoration in the patient. To our knowledge, this is the first report of spontaneous bilateral DMD in the late postoperative period after cataract extraction.

We report the case of a 46-year-old man with pellucid marginal degeneration who had uneventful placement of Intacs intrastromal corneal ring segments (Addition Technology) in the left eye because of poor best spectacle-corrected visual acuity and contact lens intolerance. The IntraLase femtosecond laser (IntraLase Corp.) was used to create the channels for the 2 ring segments. Initially, there was subjective visual improvement and the Intacs segments were well positioned. One week after surgery, corneal edema secondary to a large inferior Descemet membrane detachment was seen. The Intacs segments were removed, and an air bubble was placed in the anterior chamber. The Descemet detachment did not resolve, and penetrating keratoplasty was eventually performed.

We report 2 patients who developed delayed-onset isolated central Descemet membrane (DM) blister-like detachment following phacoemulsification. The detachments were not associated with a DM tear or inadvertent injection of fluid under DM, and no fluid tracks from the periphery were present. When the detachments failed to resolve spontaneously over several months, intracameral air or C(3)F(8) gas was injected. In 1 patient, a therapeutic paracentral puncture in DM was also performed to facilitate escape of the entrapped fluid. Although a small residual detachment (confirmed by optical coherence tomography) remained in both cases, the visual acuity improved to 20/25 in 1 patient and 20/30 in the other. We think these unique focal detachments in DM may be associated with an underlying preexisting weakness in the DM attachment to the stroma.

We describe a technique that uses trypan blue dye to identify residual recipient corneal stroma and Descemet membrane (DM) during conversion of deep anterior lamellar keratoplasty (DALK) to penetrating keratoplasty (PKP). After the host cornea is dissected, trypan blue dye (0.06%) is used to highlight the remaining host corneal stroma and DM, if any. In 8 DALK procedures that had to be converted to PKP because of DM perforation, trypan blue staining identified remnants of DM and parts of the posterior corneal stroma in 7 eyes. Improved visualization of the residual host tissue enabled complete excision and an overall optimal recipient wound profile.

Purpose: To compare the changes in the histomorphology and immunofluorescence of collagen type I in clear corneal incisions (CCIs) at the end of bimanual and coaxial phacoemulsification in rabbits., Setting: Iladevi Cataract and IOL Research Centre, Ahmedabad, India., Methods: In this randomized study, the left eye of 30 rabbits had bimanual phacoemulsification through 1.2 mm CCIs for phaco tip access accompanied by an additional 1.4 mm incision for irrigating chopper access or coaxial phacoemulsification through a 2.6 mm single-plane CCI. The right eyes acted as controls. Samples collected at the end of surgery were processed for histomorphology using periodic acid-Schiff-hematoxylin staining and immunofluorescence localization of type I collagen., Results: Incisions exposed to bimanual phacoemulsification had loss of epithelium, stromal fiber shrinkage, keratocyte nuclei fragmentation and condensation, ragged tunnel margins, and Descemet membrane and endothelial cell loss. The changes were minimal or absent in incisions exposed to coaxial phacoemulsification. Immunofluorescence showed a loss of parallel arrangement of type I collagen fibers in bimanual phacoemulsification incisions, while the fibers were well preserved in coaxial phacoemulsification incisions. The changes were more prominent in the roof of the incision tunnel than in the floor., Conclusions: Corneal incisions for bimanual phacoemulsification were more prone to damage than those for coaxial phacoemulsification. This may be attributed to the absence of a sleeve, which places the incision tunnel in direct contact with the metal phaco tip.

We present a case of keratoconus in which the association with posterior polymorphous corneal dystrophy was established by confocal microscopy. Confocal microscopy enable us to assess the differential diagnosis between posterior corneal dystrophies, essential for a prognosis and therapeutic decision.

We present a patient with residual Descemet's membrane diagnosed by anterior segment optical coherence tomography (AS-OCT) after Descemet's stripping endothelial keratoplasty (DSEK). Postoperatively, persistent partial corneal edema and interface fluid without dislocation of the donor button were observed. No improvement of interface fluid was found during the follow-up period. A primary donor graft failure was diagnosed within 4 months, and the patient was regrafted with penetrating keratoplasty. Pathology examination of the specimen revealed the presence of residual Descemet's membrane in the recipient corneal button, confirmed using AS-OCT imaging. This case report demonstrates that inadequate Descemet's stripping in the recipient button could be a potential cause of DSEK failure; AS-OCT is a useful and noninvasive instrument for diagnosing and monitoring this post-DSEK complication.

Purpose: To present clinical findings of a cluster of cases of toxic anterior segment syndrome (TASS) after uneventful phacoemulsification cataract surgery., Setting: Department of Ophthalmology, Akdeniz University, Antalya, Turkey., Methods: Six eyes of 6 patients developed TASS after uneventful phacoemulsification cataract surgery with implantation of a 3-piece acrylic IOL performed by 2 ophthalmologists on the same day. Clinical findings included corneal edema, Descemet's membrane folds, anterior chamber reaction, fibrin formation, and irregular, dilated, and unreactive pupils., Results: Glutaraldehyde 2% solution was used inadvertently by the operating room staff who cleaned and sterilized reusable ocular instruments before autoclaving. None of the affected corneas improved. Additional surgical procedures were required and included penetrating keratoplasty, trabeculectomy, and glaucoma tube implantation., Conclusions: Glutaraldehyde in concentrations generally used for cold sterilization is highly toxic to the corneal endothelium. The operating room staff involved in sterilizing instruments should be well educated about and careful to follow the protocols to properly clean and sterilize reusable ocular instruments.

During clear corneal temporal phacoemulsification, an accidental iatrogenic descemetorhexis occurred. The entire cornea was hazy and edematous on the first postoperative day. By the 1-month postoperative review, the cornea had become clear with visible descemetorhexis margins; best corrected visual acuity was 20/25, and the pachymetry was 556 microm. The patient remained stable at the 2-years postoperative follow-up, and specular microscopy done at this time showed a cell density of 1301 cells/mm2 with evidence of pleomorphism and polymegethism. This is the first report of iatrogenic descemetorhexis in which the cornea had become clear and nonedematous by as early as 1 month postoperatively. This case highlights that a healthy endothelium can maintain corneal deturgescence despite a low endothelial cell count. Corneal thickness increases only when the number of endothelial cells has gone below a physiologic lower limit.

Purpose: To correlate trabeculo-Descemet's membrane (TDM) changes with a late rise in intraocular pressure (IOP) in patients with successful viscocanalostomy., Setting: Consultores Oftalmológicos, Hospital Oftalmológico Santa Lucía, and Centro de Estudios Médicos e Investigación, Buenos Aires, Argentina., Methods: Patients who had a viscocanalostomy between July 1998 and September 2001 were retrospectively studied. Gonioscopy was performed in all patients. A subgroup of patients who had a late increase in IOP and were successfully treated with neodymium:YAG (Nd:YAG) laser goniopuncture were studied to correlate gonioscopic findings. Ultrasound biomicroscopy was performed in 10 cases. Intraocular pressure measurements were taken before viscocanalostomy and before and after Nd:YAG treatment., Results: Sixty-eight eyes of 48 patients had a viscocanalostomy to control IOP. Twenty-six eyes had a late increase in IOP and were successfully treated with Nd:YAG laser goniopuncture. Before goniopuncture, 17 eyes (65.30%) had a concave TDM. The mean IOP in these patients increased from 14.27 mm Hg to 18.73 mm Hg (range 14 to 27 mm Hg). Goniopuncture was performed a mean of 10.7 months (range 1 to 36 months) after surgery. After Nd:YAG treatment, the TDM was flat in all patients who had a concave TDM before treatment. At the last examination, the mean IOP was 13.8 mm Hg, a mean decrease of 52.24% from the baseline preoperative IOP; 61.5% of eyes had a final IOP of 14.0 mm Hg or lower., Conclusions: A concave TDM was associated with a late IOP rise. The TDM was flat after laser goniopuncture and normalization of IOP.

Retained Descemet's membrane is a rare complication of penetrating keratoplasty (PKP). The membrane can become progressively opaque and threaten the health of the corneal graft. We report such a case involving a 53-year-old man. Simultaneous surgical removal of the membrane and phacoemulsification with intraocular lens implantation were performed 3 months after PKP. The graft remained clear and best corrected visual acuity was 20/20 2 years after secondary surgery.

A 79-year-old woman had left eye phacoemulsification complicated by inadvertent excision of Descemet's membrane (DM). One day postoperatively, the visual acuity was counting fingers with diffuse corneal edema. The patient was treated medically, with gradual resolution of the corneal edema over a 6-month period. The torn edge of DM could be visualized as the edema cleared, and no endothelial cell count could be obtained centrally. Approximately 1 year postoperatively, the central endothelial cell count was 2114 cells/mm(2) in the right eye and 827 cells/mm(2) in the left eye. The decreased cell count, increased polymegethism, and pleomorphism suggested that endothelial cells migrated to cover the stromal surface area in the absence of DM.

We report 3 cases of Descemet's membrane detachment detected 2 to 3 weeks after surgery that was treated by intracameral injection of perfluoropropane 14% (C(3)F(8)) isoexpansile mixture. We looked at the predisposing factors, the best method of treatment, and the final outcome in cases of Descemet's membrane detachment following phacoemulsification.

We report the spontaneous resolution of a massive detachment of Descemet's membrane 10 months after uneventful phacoemulsification. Diagnosis of the detachment was delayed because of severe corneal edema; thus, surgery was not performed. We propose that this complication of severe corneal edema after cataract surgery be considered and, given its excellent outcome, we recommend surgical treatment.

A 6.0 x 4.0 mm pre-Descemet's membrane hemorrhage with very sharp borders appeared at the temporal portion of the cornea. There was no hyphema in the anterior chamber on the first day after secondary intraocular lens implantation. The hemorrhage resolved almost totally in 1 year without intervention, leaving slight, deep pigmentary changes and minimal diffuse corneal edema.

An unusual case of spontaneous corneal perforation of acute hydrops in the left eye of a 21-year-old man is presented. The patient had a history of atopic diseases. To evaluate the status of the other eye, corneal topographic analysis was performed. This confirmed a subclinical keratoconus in the fellow eye and the association with atopy, eye rubbing, and rapid progression of the ectasia leading to perforation.

Purpose: To determine predisposing factors, best method of treatment, and the final outcome in cases of Descemet's membrane detachment., Setting: A tertiary care teaching eye hospital., Methods: All cases of Descemet's detachment from January 1986 to May 1994 were retrospectively reviewed. Twelve eyes of 11 patients with partial or total detachment of Descemet's membrane were identified. Patients with small localized detachments at the incision area were excluded., Results: All but one patient had surgical repair. Ten eyes had successful reattachment after up to four attempts at repair. Methods of repair included intracameral air or sulfur hexafluoride (SF6) 20% gas, with or without corneal sutures. After a followup of 3 to 79 months, eight eyes retained clear corneas, four eyes developed corneal edema and scarring, and two required penetrating keratoplasty. No definite predisposing factor could be identified, although four eyes had preoperative diagnoses of glaucoma and recent corneal edema., Conclusion: Surgical repair with injection of intracameral air or SF6 20% was successful in most cases of Descemet's membrane detachment. A preoperative diagnosis of glaucoma and a recent episode of corneal edema may increase the risk of detachment.

Extensive Descemet's membrane detachment persisted after small incision cataract surgery in three patients. Unfolding and repositioning of Descemet's membrane by sodium hyaluronate (Healon) were followed by injection of sulfur hexafluoride 20% gas mixed with air to fill the anterior chamber. Initially, the gas bubble filled most of the anterior chamber; it disappeared over 7 to 9 days. Descemet's membrane remained attached, and the corneal edema cleared.

This paper describes four cases of localized bullous separation of Descemet's membrane that occurred from more than 1 year to 7 years after cataract surgery. In all eyes, fluid resembling a hypopyon (pseudohypopyon) filled the space created by the separation. In three cases, the fluid was white. In one of these, pathological examination of the fluid showed mostly necrotic but a few viable squamous epithelial cells. In the fourth case in which the fluid was whitish red, there were many capillaries along the edge of the separation and there was evidence of injury to the nearby epithelium. The one case with poor visual acuity improved after the fluid was removed.

Detachment of Descemet's membrane is a rare but serious complication of cataract surgery. Most surgeons attempt to reposition the membrane by injecting air, slow-reabsorbing gases, or viscoelastic substances into the anterior chamber. We describe five cases of subtotal detachment without rolled scroll. These cases recovered spontaneously after two to three months. We believe that conservative treatment in such cases is indicated and has a good chance of favorable outcome.

We repaired three unselected cases of Descemet's membrane detachment. A visually successful outcome was achieved in one case, an anatomically successful outcome in another, and no improvement in the last. We believe that large detachments should be repaired early rather than waiting for possible spontaneous reattachment, and we advocate sulfur hexafluoride fluid-gas exchange as the procedure of choice.

Rabbit corneal endothelial cells were transplanted into the right eyes of four New Zealand white rabbits using bovine Descemet's membrane as a cell carrier. Descemet's membranes were dissected from cow eyes, flattened on 36 mm culture dishes, and cut into discs with a 6 mm trephine. Rabbit corneal endothelial cells were seeded onto the discs and maintained in tissue culture conditions for seven days until a complete monolayer with a cell density of 3,000 cells/mm2 was formed. Before transplantation, corneal edema was induced in the host animals by an endothelial scrape wound, which removed the corneal endothelium. Five weeks later, the animals were prepared for transplantation. A corneal button was cut and placed on a dissection table so the host Descemet's membrane could be removed. The donor Descemet's membrane with a complete monolayer of rabbit corneal endothelial cells was placed on the stroma of the corneal button. To keep the donor membrane in place, the button was cauterized at three peripheral points and sutured back into the host eye. Prednisolone sodium phosphate eyedrops and dexamethasone eyedrops and ointment were applied twice daily during the post-operative period. All grafts stayed clear for a period of 12 to 17 weeks. This study shows the potential for using Descemet's membrane as a carrier for corneal endothelial cell transplantation.