Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons

Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons

Sidra Zafar,1 Jack S Parker,2,3 Christa de Kort,3,4 Gerrit Melles,3,4 Shameema Sikder11Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA; 2Parker Cornea, Birmingham, AL, USA; 3Netherlands Institute for Innovative Ocular Surgery-United States of America, Sa...

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Autores principales: Zafar S, Parker JS, de Kort C, Melles G, Sikder S
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
DMEK
uptake
barriers
difficulties.
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/08e5fa47340d471ab24e0d541ad78d79
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spelling oai:doaj.org-article:08e5fa47340d471ab24e0d541ad78d792021-12-02T02:58:51ZPerceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons1177-5483https://doaj.org/article/08e5fa47340d471ab24e0d541ad78d792019-06-01T00:00:00Zhttps://www.dovepress.com/perceived-difficulties-and-barriers-to-uptake-of-descemets-membrane-en-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sidra Zafar,1 Jack S Parker,2,3 Christa de Kort,3,4 Gerrit Melles,3,4 Shameema Sikder11Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA; 2Parker Cornea, Birmingham, AL, USA; 3Netherlands Institute for Innovative Ocular Surgery-United States of America, San Diego, CA, USA; 4Melles Cornea Clinic, Rotterdam, NetherlandsPurpose: To determine barriers related to implementation of Descemet’s membrane endothelial keratoplasty (DMEK) among corneal surgeons.Methods: This was a multicenter survey study of all corneal surgeons who participated in a DMEK wet lab organized by the Netherlands Institute for Innovative Ocular Surgery. Data related to barriers limiting uptake of DMEK surgery, self-perceived levels of competence, and difficulty with different steps of DMEK surgery were analyzed.Results: The survey response rate was 31% (22 of 72). The most common barrier to uptake of DMEK surgery identified was anxiety related to incorrect insertion of the tissue and the need to regraft (64%, 14 of 22), followed by anxiety related to tissue preparation (50%, eleven of 22). Surgeons also felt anxious regarding the possibility of rebubbling with initial DMEK (41%, nine of 22). Steps related to DMEK graft (76%) preparation, tissue insertion (41%), and graft unfolding (72%) were identified as the most difficult steps to learn by the respondents.Conclusion: The DMEK learning curve, especially for the novice surgeon, may be shortened by seeking educational resources, including wet labs and surgical videos. Eye banks may facilitate adoption of DMEK by making validated DMEK tissue more accessible to surgeons globally.Keywords: DMEK, uptake, barriers, difficultiesZafar SParker JSde Kort CMelles GSikder SDove Medical PressarticleDMEKuptakebarriersdifficulties.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1055-1061 (2019)
institution DOAJ
collection DOAJ
language EN
topic DMEK
uptake
barriers
difficulties.
Ophthalmology
RE1-994
spellingShingle DMEK
uptake
barriers
difficulties.
Ophthalmology
RE1-994
Zafar S
Parker JS
de Kort C
Melles G
Sikder S
Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
description Sidra Zafar,1 Jack S Parker,2,3 Christa de Kort,3,4 Gerrit Melles,3,4 Shameema Sikder11Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA; 2Parker Cornea, Birmingham, AL, USA; 3Netherlands Institute for Innovative Ocular Surgery-United States of America, San Diego, CA, USA; 4Melles Cornea Clinic, Rotterdam, NetherlandsPurpose: To determine barriers related to implementation of Descemet’s membrane endothelial keratoplasty (DMEK) among corneal surgeons.Methods: This was a multicenter survey study of all corneal surgeons who participated in a DMEK wet lab organized by the Netherlands Institute for Innovative Ocular Surgery. Data related to barriers limiting uptake of DMEK surgery, self-perceived levels of competence, and difficulty with different steps of DMEK surgery were analyzed.Results: The survey response rate was 31% (22 of 72). The most common barrier to uptake of DMEK surgery identified was anxiety related to incorrect insertion of the tissue and the need to regraft (64%, 14 of 22), followed by anxiety related to tissue preparation (50%, eleven of 22). Surgeons also felt anxious regarding the possibility of rebubbling with initial DMEK (41%, nine of 22). Steps related to DMEK graft (76%) preparation, tissue insertion (41%), and graft unfolding (72%) were identified as the most difficult steps to learn by the respondents.Conclusion: The DMEK learning curve, especially for the novice surgeon, may be shortened by seeking educational resources, including wet labs and surgical videos. Eye banks may facilitate adoption of DMEK by making validated DMEK tissue more accessible to surgeons globally.Keywords: DMEK, uptake, barriers, difficulties
format article
author Zafar S
Parker JS
de Kort C
Melles G
Sikder S
author_facet Zafar S
Parker JS
de Kort C
Melles G
Sikder S
author_sort Zafar S
title Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
title_short Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
title_full Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
title_fullStr Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
title_full_unstemmed Perceived difficulties and barriers to uptake of Descemet’s membrane endothelial keratoplasty among surgeons
title_sort perceived difficulties and barriers to uptake of descemet’s membrane endothelial keratoplasty among surgeons
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/08e5fa47340d471ab24e0d541ad78d79
work_keys_str_mv AT zafars perceiveddifficultiesandbarrierstouptakeofdescemetrsquosmembraneendothelialkeratoplastyamongsurgeons
AT parkerjs perceiveddifficultiesandbarrierstouptakeofdescemetrsquosmembraneendothelialkeratoplastyamongsurgeons
AT dekortc perceiveddifficultiesandbarrierstouptakeofdescemetrsquosmembraneendothelialkeratoplastyamongsurgeons
AT mellesg perceiveddifficultiesandbarrierstouptakeofdescemetrsquosmembraneendothelialkeratoplastyamongsurgeons
AT sikders perceiveddifficultiesandbarrierstouptakeofdescemetrsquosmembraneendothelialkeratoplastyamongsurgeons
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