ArticleInternational ophthalmology2026
Learning curve and procedural standardization in liquid-bubble DMEK: impact on preparation efficiency, complication rates, and endothelial cell survival.
Article in International ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAnalyzing experience-related changes and procedural standardization in DMEK using liquid-bubble preparation technique.
methodsIn this retrospective single-center study, 2929 eyes underwent DMEK between 2014 and 2024. The first and last 50 DMEK procedures for Fuchs endothelial corneal dystrophy performed by seven surgeons were compared (Block 1 vs. Block 2). Outcomes included surgical time, intraoperative complications, rebubbling, repeat DMEK, corrected distance visual acuity (CDVA), central corneal thickness (CCT), and endothelial cell density (ECD) up to 12 months.
resultsMean graft preparation time decreased by 30% (p = 0.013). Mean surgical duration decreased significantly over time in both isolated DMEK and Triple-DMEK procedures across all surgeons, with operative times reduced by 26.3% and 21.8%, respectively (all p ≤ 0.001). Preparation-related complications declined (33% vs. 18%; p < 0.01), as did intraoperative graft turning (22.9% vs. 10.6%; p < 0.001) and repeat DMEK rates (10.9% vs. 4.9%; p = 0.005). Rebubbling rates remained unchanged (32.9% vs. 30.3%; p = 0.63) but were associated with lower 12-month ECD (p < 0.001). Postoperative graft turning was also associated with reduced ECD (p = 0.02). Despite lower donor ECD in Block 2 (p < 0.001), 12-month ECD and endothelial cell loss did not differ between blocks.
conclusionsLiquid-bubble DMEK was associated with improved efficiency and reduced complication rates over time. These temporal changes were observed during a period of increasing surgical experience and progressive procedural standardization. Long-term endothelial outcomes remained stable and largely independent of individual surgeons, while rebubbling and graft turning were the main determinants of endothelial cell loss.
Indexed as
Identifiers
42527719What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.