Reply

We would like to thank Thanos et al for their interest in our report and their valuable comments on Descemet membrane epiretinal graft (DMEG) for refractory macular hole.1 We agree that our surgical technique may carry some risks including bacterial and fungal infection. Thankfully, such infections after endothelial keratoplasty are rare. Moreover, because DMEG does not require functional endothelium, supplementation with antimicrobial agents or confirmation of culture negativity are possible before distribution and use. Although gamma-irradiated corneas have become commercially available, the need for proprietary technology for tissue processing likewise results in limited access. Although initial results from retrospective case series on keratoplasty have been published,2 the safety and efficacy of gamma-irradiated corneas have yet to be established. We look forward to the clinical results of the use of electron beamirradiated Descemet membrane for macular hole surgery.