A surgical technique for donor tissue harvesting for descemet membrane endothelial keratoplasty.
OBJECTIVE
To create a reproducible and effective technique in donor tissue harvesting for Descemet membrane (DM) endothelial keratoplasty.


METHODS
A new method has been developed for the harvest of donor DM and endothelium. This method involves placement of a human corneoscleral rim in an artificial anterior chamber with removal of the anterior stroma with a Moria One microkeratome (Moria USA, Doylestown, PA). The residual stromal bed over the central cornea is removed by blunt dissection using a Barraquer sweep. A thin rim of posterior residual stroma permits easy donor button trephination and tissue manipulation. The risk of tearing through DM is minimal and may not preclude use in transplantation. This method allows relatively easy assessment of endothelial integrity before trephination.


RESULTS
Optical coherence tomography evaluation revealed minimal stroma overlying DM and endothelium. Endothelial cell integrity of the harvested DM by this new harvest method was assessed using specular microscopy and demonstrated minimal loss after DM harvest.


CONCLUSIONS
We presented a manual tissue harvest method for DM endothelial keratoplasty.
Sikder
Shameema
S
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Ward
Donald
D
Jun
Albert S
AS
D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000517:prevention & control; D015925:Cryopreservation; D003886:Descemet Membrane / Q000166:cytology*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000166:cytology*; D006801:Humans; D009926:Organ Preservation / Q000379:methods; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D041623:Tomography, Optical Coherence