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Updated: Mar 1, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Histopathology of Failed Descemet Membrane Endothelial Transfer
Jack Parker1, Robert M Verdijk, Thomas M Müller
1Melles Cornea Clinic Rotterdam (J.P., T.M.M., I.L., G.R.J.M.), Rotterdam, the Netherlands; Netherlands Institute for Innovative Ocular Surgery (J.P., T.M.M., I.L., M.B., G.R.J.M.), Rotterdam, the Netherlands; Parker Cornea (J.P.), Birmingham, AL; Department of Pathology (R.M.V.), Section Ophthalmic Pathology, ErasmusMC University Medical Center, Rotterdam, the Netherlands; Department of Ophthalmology and Visual Science (K.C.), University of Chicago, Chicago, IL; Gavin Herbert Eye Institute (P.S.B.), University of California, Irvine, CA; Amnitrans EyeBank Rotterdam (G.R.J.M.), Rotterdam, the Netherlands.
Objectives:
To describe the postmortem histologic features after an unsuccessful Descemet membrane endothelial transfer (DMET) and assess any potential clinical implications.
Methods:
Postmortem, an eye from a patient who previously underwent unsuccessful DMET for pseudophakic bullous keratopathy (PPBK) was harvested and processed for morphologic evaluation.
Results:
Clinically and histologically, the host cornea showed evidence of diffuse stromal edema. Although the edges of the surgical descemetorhexis were well visualized, there was no evidence of endothelial migration or repopulation of the posterior stroma from any direction. A multilayered, retrocorneal membrane was present that appeared to originate from the trabecular meshwork.
Conclusions:
Descemet membrane endothelial transfer and "descemetorhexis alone" may be insufficient treatment for eyes operated on for PPBK, that is, eyes with a significantly depleted or dysfunctional endothelium.
