New 'absolutely no-touch' DMEK preparation technique

I want to show in this video an absolutely new technique for DMEK preparation. Since we do not touch the final graft at all we call it 'absolutely no-touch'. First step ist removing tight trabecular meshwork remnants, then the area of preparation is stained with Trypan blue. By using blunt thin instruments as an Sinskey hook or Binkhorst spatula an tight sub-Descemet tunnel of approximately 2-3 mm length is created and just as wide as an Sauter cannula. Next, the trypan blue syringe connected to a Sauter cannula is inserted into the tunnel and the dye solution is gently injected into the sub-Descemet space in order to create a 'liquid bubble'. Beside the fact that the final graft is not touched at all, the graft is also deeply stained on Descemet side. After a short learning curve the procedure only takes a few minutes.

[@Abysiz]

Interesting technique. Thank you for sharing.
How do you manage cataract incision on the donor graft with a potentially rupture due to the scars ?
Thank you

[@SurgeonFishing]

Did you use a simsky, or needle to make the initial tunnel?
And what gauge is the cannula for injecting the vision blue?
How do you ensure the graft is in the Orientation without marking? Just Moutsuri sign?
Thanks

[@OMAR.MOHAMMED88]

Is there a Risk for Descement membrane Rupture?

[@martindirisamer9054]

Risk for a major rupture is very little... little tears at the entry may happen - I suggest switching the location 180degree

[@OMAR.MOHAMMED88]

Thank you for your valuable Tipps