Precut DMEK Using Dextran-Containing Storage Medium Is Equivalent to Conventional DMEK: A Prospective Pilot Study

Cornea. 2019 Jan;38(1):24-29. doi: 10.1097/ICO.0000000000001778.

Abstract

Purpose: To compare the clinical outcome after Descemet membrane endothelial keratoplasty (DMEK) either as precut or conventional Descemet membrane graft preparation under standard European eye bank organ culture conditions.

Methods: This was a prospective pilot study of patients receiving either precut or conventional DMEK. Graft preparation was performed using the liquid bubble technique. Precut grafts (n = 22) were prepared 1 day before surgery in the eye bank and stored in dextran-containing organ culture medium within a transport viewing chamber. Conventional grafts (n = 29) were prepared directly before surgery. End point criteria included the endothelial cell count (ECC), central corneal thickness, graft rejection rate, rebubbling rate, and best-corrected visual acuity after 1, 3, and 6 months.

Results: A post hoc matched analysis revealed no statistically significant differences between the 2 groups. The ECC in the precut and conventional groups was comparable with an EC loss of 34% and 35%, respectively, after 6 months. The early graft failure rate, best-corrected visual acuity, and central corneal thickness were comparable between the 2 groups.

Conclusions: This pilot study shows a comparable clinical outcome after DMEK surgery for precut Descemet membrane grafts versus conventionally prepared grafts, using the liquid bubble preparation technique and storage conditions with dextran-containing medium.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Descemet Membrane / surgery*
  • Descemet Stripping Endothelial Keratoplasty / methods*
  • Dextrans / pharmacology*
  • Endothelium, Corneal / pathology
  • Eye Banks*
  • Female
  • Follow-Up Studies
  • Fuchs' Endothelial Dystrophy / pathology
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Male
  • Middle Aged
  • Organ Culture Techniques / methods*
  • Pilot Projects
  • Plasma Substitutes / pharmacology
  • Prospective Studies
  • Tissue Donors*
  • Visual Acuity

Substances

  • Dextrans
  • Plasma Substitutes