{
  "abstract": "Purpose A safety-net suture technique was developed at Moorfields Eye hospital to make DMEK feasible in cases with aphakia and aniridia. This study reports long-term outcomes from the largest case series to date of safety-net DMEK in aphakic and unicameral eyes.Methods A retrospective consecutive case series was performed of all safety-net DMEK procedures undertaken at Moorfields Eye Hospital between January 2019 and December 2024 by two surgeons performing this technique (AVP and BA). Demographic data, ocular comorbidities, best-corrected visual acuity (BCVA), rebubbling rate, and graft survival were analysed. Pre- and postoperative BCVA were converted to logMAR for statistical analysis. Paired non-parametric testing was used to compare visual outcomes.Results Twenty one eyes underwent safety-net DMEK for aphakia and aniridia. Post-op follow-up ranged from 18 months year to 65 months. Mean patient age was 65.3 years (range 40–91). Most eyes resulted in aphakia secondary to trauma or complex intraocular surgery. Most frequent coexisting pathology included glaucoma and previous retinal detachment. Median Rebubbling was required in 5/21 (23.8%). Graft failure and/or repeat graft occurred in 4/21 eyes (19%). Posterior graft dislocation was prevented in all cases. Estimated graft survival on Kaplan Meier analysis at 5 years was 65%.Conclusions Safety-net DMEK is a feasible and effective surgical option for aphakic and unicameral eyes. Statistically significant visual improvement can be achieved despite complex ocular comorbidity, with acceptable rebubbling and graft failure rates. This technique allows selected patients to benefit from the anatomical and visual advantages of DMEK and represents a viable alternative to DSAEK in complex eyes.",
  "authors": [
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Alfonso Vasquez-Perez"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Bruce Allan"
    }
  ],
  "title": "OP15 DMEK safety-net technique for eyes with aphakia and aniridia. Outcomes after six years of its development and introduction at Moorfields eye hospital",
  "uid": "33fe6744-b756-5eb2-ae4f-0b0f12b072b1"
}