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Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
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Preloaded Tissues for Descemet Membrane Endothelial Keratoplasty
Mohit Parekh1, Alessandro Ruzza1, Stefano Ferrari1
1International Center for Ocular Physiopathology, Fondazione Banca Degli Occhi Del Veneto Onlus, Venice, Italy.
American Journal of Ophthalmology
|April 13, 2016
Summary
Preloading Descemet membrane endothelial keratoplasty (DMEK) grafts in an intraocular lens cartridge is feasible for up to 4 days. This method simplifies surgery, reduces costs, and minimizes tissue waste while maintaining endothelial cell viability.
Area of Science:
- Ophthalmology
- Tissue Engineering
- Surgical Innovation
Background:
- Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure to restore vision.
- Current DMEK graft preparation and handling can be time-consuming and may lead to tissue damage.
- Standardization of graft preparation is crucial for consistent surgical outcomes.
Purpose of the Study:
- To assess the feasibility of preloading endothelial tissues for DMEK.
- To evaluate the viability and integrity of DMEK grafts after a preloading and storage period.
Main Methods:
- Human donor corneas unsuitable for transplantation were used in a laboratory setting.
- Endothelial tissues were stripped, manually tri-folded (endothelium-in), and loaded into a 2.2 intraocular lens (IOL) cartridge.
- Grafts were preserved in transport media for 4 days at room temperature.
Main Results:
- Successful preparation and loading of DMEK grafts were achieved in all cases.
- Average stripping and loading times were 20 and 4.5 minutes, respectively.
- Endothelial cell loss after 4 days of preservation was 4.35%, with minimal cell mortality and uncovered areas.
Conclusions:
- Tri-folded DMEK grafts can be preloaded and stored for up to 4 days in an IOL cartridge with minimal endothelial damage.
- Preloading DMEK grafts offers potential benefits including simplified surgery, reproducibility, reduced surgical time, and decreased tissue wastage.
- Alternative methods for graft delivery, such as bimanual pull-through, are viable.
