Endothelial Cell Viability after DMEK Graft Preparation.

Area of Science:

• Ophthalmology
• Transplantation Science
• Cell Biology

Background:

• Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure for corneal blindness.
• Ensuring the quality of donor corneal grafts is crucial for successful DMEK outcomes.
• The impact of graft preparation and storage on endothelial cell density (ECD) and viability requires careful evaluation.

Purpose of the Study:

• To assess how graft preparation and organ-culture storage affect ECD and cell viability in DMEK grafts.
• To identify potential issues in graft quality before transplantation.

Main Methods:

• DMEK grafts (n=27) were prepared at a tissue bank.
• Endothelial cell density (ECD) and viability were assessed using light microscopy (LM ECD) and Calcein-AM staining (Calcein-ECD).
• Grafts were evaluated immediately post-preparation and after 3-7 days of storage.

Main Results:

• LM evaluation showed an intact endothelial cell monolayer immediately after preparation.
• Calcein-AM staining revealed a median ECD decrease of 18% compared to LM ECD for some grafts.
• Minimal additional ECD changes (1-2%) were observed during 3-7 days of storage, with viable cell coverage increasing from 88% to 92%.

Conclusions:

• Most DMEK grafts maintain cell viability after preparation and storage.
• Some grafts may show endothelial cell damage within hours post-preparation.
• Implementing pre-transplantation ECD evaluation in eye banks can improve DMEK outcomes.