Descemet membrane air-bubble separation in donor corneas

Abstract

We describe a technique to obtain Descemet-endothelium disks from donors. To detach Descemet membrane, an air bubble was introduced in the deep stroma of human donor corneas mounted on an artificial chamber. In Group A (n = 5), the bubble was left inflated. In Group B (n = 4), the bubble was deflated immediately after the membrane was detached. In Group C (n = 7), the Descemet-endothelium disk was trephined and separated from the stroma after the bubble was deflated. All tissues were stored at 4°C. Descemet detachment was achieved in 89% of the tissues. After 48 hours, the mean endothelial loss was 83% ± 10% (SD), 15% ± 11%, and 3% ± 3% in the 3 groups, respectively. With this technique, Descemet-endothelium disks were obtained without significant alterations in the endothelial layer.

Glued Intrascleral Fixation of Intraocular Lens With Pupilloplasty and Pre-Descemet Endothelial Keratoplasty

“…[19][20][21][22][23][24] In our series, a type-1 bubble was formed in all the cases, and no loss of tissue during the process of creation of bubble was reported both with the adult and infant donor cornea. 6,8,9 During the combined procedure, no difficulty was encountered in unfolding the PDEK graft because the addition of the PDL layer to the Descemet membrane (DM)-endothelium complex provides it with an extra splinting effect.…”

Novel liquid bubble dissection technique for DMEK lenticule preparation

“…Many new dissection techniques have been described in the recent past with the goal of less harmful preparation while yielding a more effective time and tissue management [4][5][6][7][8][9][10].…”

“…Therefore, a focus of recent investigations was put on Descemet's membrane (DM) dissection techniques [4][5][6][7][8][9][10]. Salvaio and colleagues reported about a novel 'SubHyS' technique for DMEK lenticule preparation [10].…”

Evolving Techniques in Corneal Transplantation

“…In SCUBA, the cornea is submerged in Optisol or BSS during harvesting to mitigate surface tension, and to allow the DM to settle onto the stroma. Pneumatic dissection is another alternative to manual peeling of the DM [51–53]. As in DALK, pneumatic dissection in DMEK involves injecting air into the cornea to create a dissection plane between the donor stroma and DM.…”