Related Experiment Video
Updated: May 3, 2026
10:46
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
14.8K
Descemet membrane endothelial keratoplasty donor preparation: navigating challenges and improving efficiency
Lawrence R Tenkman1, Francis W Price, Marianne O Price
1*Bennett and Bloom Eye Centers, Louisville, KY; †Price Vision Group, Indianapolis, IN; and ‡Cornea Research Foundation of America, Indianapolis, IN.
Cornea
|January 24, 2014
Summary
Descemet membrane endothelial keratoplasty (DMEK) donor preparation is highly successful (99%) with proper techniques, even for novice surgeons. Avoid using the mate cornea if one shows multiple horseshoe-shaped tears (HSTs) due to preparation challenges.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Engineering
Background:
- Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure for endothelial dysfunction.
- Donor tissue preparation is critical for successful DMEK outcomes.
- Challenges in preparing DMEK donor tissue can impact surgical success rates.
Purpose of the Study:
- To detail the challenges encountered during Descemet membrane endothelial keratoplasty (DMEK) donor tissue preparation.
- To present strategies for improving the success rate of DMEK donor preparation.
- To evaluate the outcomes of DMEK preparation by a novice surgeon.
Main Methods:
- A series of 263 consecutive DMEK donor preparation attempts were analyzed.
- Donor corneas were submerged in storage medium during Descemet membrane (DM) and endothelium peeling.
- Surgeon experience level and preparation outcomes were recorded.
Main Results:
- A 99% success rate was achieved in preparing DMEK donor tissue.
- 1.1% of preparations failed due to adherence issues causing horseshoe-shaped tears (HSTs) in the DM.
- HSTs occurred in 13% of preparations; contralateral corneas showed increased risk (60-80%) of HSTs if one cornea was affected.
Conclusions:
- DMEK donor preparation can be highly successful with appropriate techniques, even for novice surgeons.
- If a donor cornea exhibits multiple HSTs, its mate should not be used for DMEK due to elevated preparation risks.
- Identifying and managing preparation challenges like HSTs is crucial for optimizing DMEK outcomes.
