Precut DMEK Using Dextran-Containing Storage Medium Is Equivalent to Conventional DMEK: A Prospective Pilot Study

Area of Science:

• Ophthalmology
• Corneal Surgery
• Tissue Engineering

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure for endothelial dysfunction.
• Graft preparation methods for DMEK include conventional and precut techniques.
• Standardized organ culture conditions are crucial for graft viability.

Purpose of the Study:

• To compare the clinical outcomes of DMEK using precut versus conventionally prepared Descemet membrane grafts.
• To evaluate graft preparation methods under standard European eye bank organ culture conditions.
• To assess the impact of graft preparation on endothelial cell count and visual acuity.

Main Methods:

• A prospective pilot study involving patients undergoing DMEK with either precut or conventional grafts.
• Graft preparation utilized the liquid bubble technique.
• Precut grafts were prepared 1 day prior to surgery and stored; conventional grafts were prepared immediately before surgery.
• Outcome measures included endothelial cell count, corneal thickness, rejection rates, rebubbling, and visual acuity at 1, 3, and 6 months.

Main Results:

• Post hoc matched analysis showed no statistically significant differences between precut and conventional DMEK groups.
• Endothelial cell loss after 6 months was comparable: 34% for precut and 35% for conventional grafts.
• Early graft failure rates, best-corrected visual acuity, and central corneal thickness were similar in both groups.

Conclusions:

• Precut Descemet membrane grafts demonstrate comparable clinical outcomes to conventionally prepared grafts in DMEK surgery.
• The liquid bubble preparation technique and dextran-containing medium storage are suitable for precut grafts.
• This pilot study supports the feasibility and efficacy of precut grafts in DMEK.