Causes of Primary Donor Failure in Descemet Membrane Endothelial Keratoplasty

Unexpectedly, graft failure after DMEK may not primarily result from tissue damage during implantation and associated endothelial cell loss. Detached grafts may therefore be managed by early reposition. When the graft is attached after surgery but fails to clear, secondary surgical intervention may be postponed, because these corneas may clear spontaneously after several weeks.