title: Technique for preparation of the corneal endothelium-Descemet membrane complex for transplantation.
abstract: OBJECTIVE
  Replacing diseased corneal endothelium with a preparation of Descemet membrane carrying functional endothelium and no stroma may be a feasible method for treating corneal endothelial decompensation. To obtain a viable donor of a Descemet membrane endothelium disc, we modified the Descemet membrane stripping technique and monitored the percentage of endothelial damage to the donor tissue preparation.
  
  
  METHODS
  Forty-eight human corneas were used. Cornea buttons were mounted on an artificial anterior chamber, endothelial side up. Endothelia were stained with alizarin red, examined under the microscope, and photographed at 5 different sites (microscope, x100; digital magnification, x2.83). A 6 x 7-mm rectangular piece of endothelium-Descemet membrane complex was obtained using a Grieshaber microsurgical knife and Kelman-McPherson forceps. Digital photographs of endothelia were analyzed with a computer, and the percentage of endothelial damage was calculated. Specimens were processed for hematoxylin-eosin staining.
  
  
  RESULTS
  Forty of 48 endothelium-Descemet membrane preparations (83.3%) were complete peels with minimal endothelial damage. Endothelial damage before and after the surgery was 1.57 +/- 2.11% and 2.61 +/- 1.77%, respectively. Eight preparations (16.7%) failed because of tearing. Multiple hematoxylin-eosin-stained sections showed the presence of endothelium with intact Descemet membrane and no stromal tissue.
  
  
  CONCLUSIONS
  We modified the technique of Melles and obtained a sheet of Descemet membrane and endothelium with minimal endothelial damage and with no remaining stroma observed. This simple technique can be used to obtain the endothelium-Descemet membrane complex in minutes. It may be useful for corneal endothelium transplantation.
authors.affiliation: Doheny Eye Institute, Los Angeles, CA 90033, USA.
authors.forename: Zejin
authors.initials: Z
authors.lastname: Zhu
authors.forename: Lawrence
authors.initials: L
authors.lastname: Rife
authors.forename: Samuel
authors.initials: S
authors.lastname: Yiu
authors.forename: Melvin D
authors.initials: MD
authors.lastname: Trousdale
authors.forename: Daniel
authors.initials: D
authors.lastname: Wasilewski
authors.forename: Alexandre
authors.initials: A
authors.lastname: Siqueira
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000880:Anthraquinones; D016039:Corneal Transplantation; D003886:Descemet Membrane; D004728:Endothelium, Corneal / Q000473:pathology / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009926:Organ Preservation; D013194:Staining and Labeling / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000379:methods*
chemical_list: D000880:Anthraquinones; C010078:alizarin