Donor Tissue Characteristics in Preparation of DMEK Grafts

Abstract

Exclusion of the contralateral eye tissue when there was difficulty in graft peeling for the first eye may prove to be a unique quality of DMEK donor tissue.

Endothelial cell loss following tissue harvesting by pneumodissection for endothelial keratoplasty: an ex vivo study

“…PDEK in its current established form was proposed by Dua and first performed by Agarwal et al 10. The fact that a type 1 BB can be created in donors of any age (our unpublished observations) would allow very young tissue with consequent higher endothelial counts to be used for PDEK compared with the conventional stripping technique used to obtain tissue for DMEK wherein it is recognised that the risk of tissue loss is greater in older donors 13 14. Moreover, the support afforded by DL makes the tissue easier to handle and unroll in the eye compared with DM alone 10.…”

Risk Factors for Eye Bank Preparation Failure of Descemet Membrane Endothelial Keratoplasty Tissue

“…In this latter context, difficulty in graft peeling for the first eye has been shown to be the most important factor for failure in the fellow eye. 11,15 Also, ultrastructural abnormalities (peg-like interlockings) or biochemical abnormalities (increased staining intensities for adhesive glycoproteins) along the Descemet membrane–stroma interface have been proposed as the main cause of tears during unsuccessful preparation. 16 A recognized association for this is young donor age, which represents a risk factor for DMEK graft preparation failure.…”

“…16 A recognized association for this is young donor age, which represents a risk factor for DMEK graft preparation failure. 10,11,16 …”

“…10 In a recent publication, Gorovoy and associates studied some risk factors for DMEK preparation, including donor age, gender, postmortem tissue time interval, contralateral eye data, peel time, and peel complications, in 116 consecutive DMEK donor tissues that were prepared by a single surgeon. 11 They proposed that the major risk factor for DMEK preparation failure in the fellow eye is complications during peeling the first eye. Another risk factor proposed was donor age younger than 50 years.…”

Novel liquid bubble dissection technique for DMEK lenticule preparation

“…Although we witnessed a higher adhesion (n = 3) and a tendency for tearing (n = 4) in those selected eyes, successful dissection was achieved in 99 % (85 of 86 eyes). It has been recently shown that donor corneas with preceding cataract surgery and diabetes mellitus are more adherent and difficult to prepare and show a higher risk for unsuccessful preparation [13,14]. It would be very interesting to know something about the cornea donors, especially concerning the status of the lens and the internal diseases.…”