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Updated: Jul 16, 2025
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Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
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Using a Cone-Shaped Glass Funnel Adapter Reduces Endothelial Cell Loss Caused by Preloading Descemet Membrane
Matthew Kigin1,2,3, Gregory Schmidt1, Benjamin Revis2,4
1Iowa Lions Eye Bank, Coralville, IA.
Cornea
|September 15, 2023
Summary
A new cone-shaped funnel significantly reduces endothelial cell loss during Descemet membrane endothelial keratoplasty (DMEK) tissue loading. This method offers a safer approach for preparing DMEK grafts, improving outcomes for corneal transplantation.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Engineering
Background:
- Descemet membrane endothelial keratoplasty (DMEK) is a surgical procedure to restore vision by replacing damaged corneal endothelium.
- Optimizing tissue preparation, particularly the loading of DMEK tissue into insertion devices, is crucial for minimizing endothelial cell loss (ECL).
- Current loading techniques may lead to significant ECL, impacting graft survival and visual outcomes.
Purpose of the Study:
- To compare the efficacy of front versus rear loading techniques for Descemet membrane endothelial keratoplasty (DMEK) tissue into micro-Jones and standard-Jones tubes.
- To evaluate the impact of a novel cone-shaped glass funnel adapter on reducing ECL during DMEK tissue loading.
Main Methods:
- Corneal tissues were stained with trypan blue to ensure equivalence between paired corneas.
- DMEK tissues were loaded using front and rear methods into micro-Jones and standard-Jones tubes, and also with a cone-shaped funnel adapter.
- Endothelial cell loss (ECL) was quantified using calcein AM staining, FIJI, and Trainable Weka Segmentation; scroll widths were measured digitally.
Main Results:
- No significant difference in ECL was observed between front and rear loading methods for either micro-Jones or standard-Jones tubes (P > 0.05).
- DMEK scrolls loaded using the cone-shaped funnel adapter demonstrated significantly lower ECL compared to those loaded through the front (2.40% vs. 13.53%, P < 0.001).
- The loading time with the funnel adapter was comparable to the front loading method (5.52 seconds vs. 6.66 seconds, P = 0.24).
Conclusions:
- The use of a cone-shaped DMEK loading funnel is effective in reducing endothelial cell loss during the preloading phase.
- This novel funnel adapter presents a promising tool for enhancing the safety and efficiency of DMEK tissue preparation.
- Implementing the funnel adapter may lead to improved graft survival rates and better visual outcomes for patients undergoing DMEK surgery.
