Donor tissue preparation for Descemet membrane endothelial keratoplasty.
OBJECTIVE
To evaluate a technique for preparing a donor Descemet membrane carrying autologous endothelium for transplantation in Descemet membrane endothelial keratoplasty (DMEK).


METHODS
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.


METHODS
A 9.5 mm diameter DM carrying autologous endothelium was stripped from 10 corneoscleral rims that had been organ cultured for 1 week. The endothelial cell density (ECD) was evaluated with light microscopy before and immediately after DM was stripped and during 4 additional weeks of organ culture.


RESULTS
The mean ECD was 2701 cells/mm(2) +/- 302 (SD) before and 2719 +/- 322 cells/mm(2) immediately after DM was stripped and declined from 2604 +/- 352 cells/mm(2) after 1 week to 2190 +/- 768 cells/mm(2) after an additional 4 weeks of organ culture (n = 10). Typical "endothelial streaks," ie, linear cellular disruptions observed immediately after DM was stripped, showed complete regeneration after the second culture period.


CONCLUSIONS
Descemet grafts for transplantation in DMEK procedures can be surgically prepared from organ-cultured corneal rims and stored for an additional 3 weeks with acceptable endothelial cell loss. Because the donor tissue can be dissected directly from organ-cultured corneoscleral rims, donor preparation for DMEK can be readily accessible to most corneal surgeons.
Lie
Jessica T
JT
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.
Birbal
Rénuka
R
Ham
Lisanne
L
van der Wees
Jacqueline
J
Melles
Gerrit R J
GR
D000328:Adult; D000368:Aged; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000473:pathology / Q000637:transplantation*; D006801:Humans; D008875:Middle Aged; D009924:Organ Culture Techniques / Q000379:methods; D013048:Specimen Handling / Q000379:methods*; D014019:Tissue Donors