Factors influencing corneal predescemetic endothelial keratoplasty (PDEK) graft creation: It's all in a bubble
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Updated: Jan 2, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
M Tsatsos1, M Mironidou, S Jacob
1Dorset County Hospital NHS Trust, Ophthalmology Department, Dorchester, UK. michaeltsatsos@gmail.com.
Aim:
To assess the effect of pneumatic (air) and fluidic (transport medium) injection to the type of bubble (I, II or mixed III) and the resultant dissection of corneal endothelial grafts PDEK or DMEK.
Materials And Methods:
All grafts were obtained from Dr Agrawal Hospital's Eye Bank. Air injection was the initial preferred mode of graft harvest. If pneumatic dissection was unsuccessful after 10 tries, fluidic dissection with transport medium was tried. SPSS 23.0 was used to statistically analyse the data.
Results:
40 consecutive donor corneas with a mean age of 46.5 and a mean endothelial count of 2980 were analysed. Air dissection lead to the harvest of 27 endothelial grafts and fluid dissection led to the creation of 7 endothelial grafts. Statistically significant difference was found the different bubble types and the type of injection (χ2 chi square=10.02, 0=0.008).
Conclusion:
In young donors pneumatic (air) graft dissection leads to PDEK in a high proportion. This percentage is reduced when transport medium is tried after unsuccessful air injection. Injection of transport medium increases the percentage of grafts harvested but also increases the ratio of Type II and III DMEK grafts created.
