Original articleReproducibility of Graft Preparations in Descemet's Membrane Endothelial Keratoplasty
Section snippets
Tissue Specimens
Corneal donor tissue (n = 350) was obtained from various eye banks in Europe and the United States. The corneoscleral buttons of European origin (n = 303) were organ cultured in Dulbecco's modified Eagle's medium containing streptomycin and penicillin (Biochrom, Berlin, Germany) as well as fetal calf serum (Linaris, Bettingen am Main, Germany) at 34°C for 368.9±100.5 hours (range, 48–672 hours). The corneoscleral buttons from US eye banks (n = 47) were stored in Optisol-GS (Bausch & Lomb,
Results
As shown in Table 1, both donor corneas stored under organ culture (n = 303) or short-term culture conditions (n = 47) were used. The ages of the tissue donors ranged from 18 to 95 years (mean, 73.4±11.2 years).
Complete and uneventful manual separation without any disruption of DM was achieved in 335 of 350 donor corneas (95.7%) by use of a previously established bimanual submerged preparation technique.15 Correspondingly, the residual EDM specimens revealed a regular ultrastructure comprising
Discussion
In posterior lamellar surgery of the cornea, DMEK represents the most recent and the ideal patient-oriented development.19 Despite its superior clinical results, as indicated by faster visual recovery, less postoperative astigmatism, and reduced risk of transplant rejection compared with other posterior lamellar procedures,3, 4, 20, 21, 22, 23 DMEK has not yet found widespread application and remains limited to a few clinical centers.19 One of the reasons may be technical challenges in
References (34)
- et al.
Descemet's membrane endothelial keratoplasty: prospective multicenter study of visual and refractive outcomes and endothelial survival
Ophthalmology
(2009) - et al.
Near complete visual recovery and refractive stability in modern corneal transplantation: Descemet membrane endothelial keratoplasty (DMEK)
Cont Lens Anterior Eye
(2013) - et al.
Donor tissue preparation for Descemet membrane endothelial keratoplasty
J Cataract Refract Surg
(2008) - et al.
Descemet membrane automated endothelial keratoplasty: hybrid technique combining DSAEK stability with DMEK visual results
J Cataract Refract Surg
(2009) - et al.
Stromal support for Descemet's membrane endothelial keratoplasty
Ophthalmology
(2010) - et al.
Descemet membrane air-bubble separation in donor corneas
J Cataract Refract Surg
(2010) - et al.
Characterization of the cleavage plane in Descemet's membrane endothelial keratoplasty
Ophthalmology
(2011) - et al.
Corneal higher-order aberrations after Descemet's membrane endothelial keratoplasty
Ophthalmology
(2012) - et al.
Risk of corneal transplant rejection significantly reduced with Descemet's membrane endothelial keratoplasty
Ophthalmology
(2012) - et al.
A technique to harvest Descemet's membrane with viable endothelial cells for selective transplantation
Am J Ophthalmol
(2005)
Split cornea transplantation for 2 recipients: a new strategy to reduce corneal tissue cost and shortage
Ophthalmology
Descemet membrane endothelial keratoplasty (DMEK)
Cornea
Visual rehabilitation rate after isolated Descemet membrane transplantation: Descemet membrane endothelial keratoplasty
Arch Ophthalmol
Efficacy of Descemet membrane endothelial keratoplasty: clinical outcome of 200 consecutive cases after a learning curve of 25 cases
Arch Ophthalmol
Donor tissue culture conditions and outcome after Descemet membrane endothelial keratoplasty
Am J Ophthalmol
Causes of primary donor failure in Descemet membrane endothelial keratoplasty
Am J Ophthalmol
Automated donor tissue preparation for Descemet membrane automated endothelial keratoplasty (DMAEK): an experimental study
Ophthalmic Surg Lasers Imaging
Cited by (63)
DMEK F-marking complication: case report and literature review
2023, Canadian Journal of OphthalmologyTissue engineered ultra-thin descemet stripping corneal endothelial layers using porcine cornea and stem cells
2020, Experimental Eye ResearchCitation Excerpt :Therefore, when human DM is separated it forms the taco roll shape because its anterior banded layers have parallel collagen fibrils, arranged sagittal of the graft. However, due to the absence of the anterior banded layer, the porcine DM graft was curled in a triangular shape, rather than in a taco roll shape (Liu et al., 2018; Schlotzer-Schrehardt et al., 2013). Although this curling tendency was not observed in the DSEK, the swollen wet graft can induce graft rolling which might destroy the extracellular matrix (ECM) arrangement.
Splitting of the Recipient's Descemet Membrane in Descemet Membrane Endothelial Keratoplasty—Ultrastructure and Clinical Relevance
2016, American Journal of OphthalmologyDescemet membrane detachment
2020, Survey of OphthalmologyCitation Excerpt :The interfacial matrix represents the adhesive zone of DM and is composed of various extracellular matrix proteins with adhesive properties, such as fibronectin, amyloid P, osteonectin, fibrillin-1, fibulin-1, fibulin-2, fibulin-3, and keratoepithelin as detected by light and electron microscopic immunohistochemistry.65 Among these, keratoepithelin protein (transforming growth factor-b-induced/TGF-b-induced) and collagen type VI serve as the main anchoring proteins.66 Schlötzer-Schrehardt and coworkers reported that the differences between distances of stromal keratocytes increase significantly from central to the midperipheral and peripheral cornea, whereas there is no significant difference between the mean numbers of collagen lamellae in the DSI.
Type II Diabetes Mellitus Causes Extracellular Matrix Alterations in the Posterior Cornea That Increase Graft Thickness and Rigidity
2023, Investigative Ophthalmology and Visual Science
Manuscript no. 2013-249.
Financial Disclosures: The authors have no proprietary or commercial interest in any of the materials discussed in this article.