Relationship Between Tissue Unscrolling Time and Endothelial Cell Loss.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Tissue Engineering

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure for endothelial dysfunction.
• Optimizing tissue handling during DMEK is crucial for graft survival.
• Understanding factors influencing intraoperative tissue manipulation is important for surgical outcomes.

Purpose of the Study:

• To investigate the correlation between the time taken to unscroll donor Descemet membrane endothelial keratoplasty (DMEK) tissue and postoperative endothelial cell loss (ECL) at six months.
• To determine if donor age, scroll tightness, or the presence of an S stamp affect intraoperative unscrolling time.

Main Methods:

• A cohort of 93 uncomplicated DMEK surgeries for Fuchs endothelial dystrophy was analyzed.
• Standardized surgical techniques and eye bank prestripped tissue were used.
• Intraoperative unscrolling times and 6-month endothelial cell densities were recorded and statistically analyzed.

Main Results:

• No significant relationship was found between intraoperative unscrolling time and 6-month endothelial cell loss (r = -0.02, P = 0.89).
• Donor age, scroll tightness, and the absence of an S stamp did not correlate with longer unscrolling times (P > 0.05).
• Limited data on iatrogenic primary graft failure showed no association with unscrolling time.

Conclusions:

• Surgeons can take adequate time to unscroll DMEK tissue in the anterior chamber without compromising endothelial health.
• The
• DMEK dance
• can be performed without undue haste, as longer unscrolling times do not appear to endanger the endothelium.