Skip to main content
Log in

Endothelial quality of pre-cut posterior corneal lamellae for Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S): two-year outcome of manual preparation in an ocular tissue bank

Cell and Tissue Banking Aims and scope Submit manuscript

Abstract

To assess the quantitative and qualitative parameters of pre-cut posterior corneal lamellae for Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S) prepared manually in the Ocular Tissue Bank Prague. All 65 successfully prepared pre-cut posterior corneal lamellae provided for grafting during a 2-year period were analyzed retrospectively. The lamellae, consisting of a central zone of endothelium-Descemet membrane surrounded by a supporting peripheral stromal rim, were prepared manually from corneoscleral buttons having an endothelial cell density higher than 2,500 cells/mm2. The live endothelial cell density, the percentage of dead cells, the hexagonality and the coefficient of variation were assessed before and immediately after preparation as well as after 2 days of organ culture storage at 31 °C. Altogether, the endothelium of 57 lamellae was assessed. Immediately after preparation, the mean live endothelial cell density was 2,835 cells/mm2 and, on average, 1.8 % of dead cells were found. After 2 days of storage, the cell density decreased significantly to 2,757 cells/mm2 and the percentage of dead cells to 1.0 %. There was a significant change in the mean hexagonality and the coefficient of variation after lamellar preparation and subsequent storage. The amount of tissue wasted during the preparation was 23 %. The endothelial cell density of posterior corneal lamellae sent for DMEK-S was higher than 2,700 cells/mm2 in average with a low percentage of dead cells; 65 pre-cut tissues were used for grafting during a 2-year period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Anwar M, Teichmann KD (2002) Big-bubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty. J Cataract Refract Surg 28(3):398–403

    Article  PubMed  Google Scholar 

  • Chen ES, Terry MA, Shamie N, Hoar KL, Friend DJ (2008) Precut tissue in Descemet’s stripping automated endothelial keratoplasty donor characteristics and early postoperative complications. Ophthalmology 115(3):497–502

    Article  PubMed  Google Scholar 

  • Cheng YY, Pels E, Cleutjens JP, van Suylen RJ, Hendrikse F, Nuijts RM (2007) Corneal endothelial viability after femtosecond laser preparation of posterior lamellar discs for Descemet-stripping endothelial keratoplasty. Cornea 26(9):1118–1122

    Article  PubMed  Google Scholar 

  • Doughman DJ, Van Horn D, Rodman WP, Byrnes P, Lindstrom RL (1976) Human corneal endothelial layer repair during organ culture. Arch Ophthalmol 94(10):1791–1796

    Article  PubMed  CAS  Google Scholar 

  • Gorovoy MS (2006) Descemet-stripping automated endothelial keratoplasty. Cornea 25(8):886–889

    Article  PubMed  Google Scholar 

  • Guerra FP, Anshu A, Price MO, Giebel AW, Price FW (2011) Descemet’s membrane endothelial keratoplasty: prospective study of 1-year visual outcomes, graft survival, and endothelial cell loss. Ophthalmology 118(12):2368–2373

    Article  PubMed  Google Scholar 

  • Ham L, Dapena I, van Luijk C, van der Wees J, Melles GR (2009a) Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy: review of the first 50 consecutive cases. Eye (London) 23(10):1990–1998

    Article  CAS  Google Scholar 

  • Ham L, van Luijk C, Dapena I, Wong TH, Birbal R, van der Wees J, Melles GR (2009b) Endothelial cell density after descemet membrane endothelial keratoplasty: 1- to 2-year follow-up. Am J Ophthalmol 148(4):521–527

    Article  PubMed  Google Scholar 

  • Ignacio TS, Nguyen TT, Sarayba MA, Sweet PM, Piovanetti O, Chuck RS, Behrens A (2005) A technique to harvest Descemet’s membrane with viable endothelial cells for selective transplantation. Am J Ophthalmol 139(2):325–330

    Article  PubMed  Google Scholar 

  • Knox Cartwrigt NE, Tyrer JR, Marshall J (2011) Age-related differences in the elasticity of the human cornea. Invest Ophthalmol Vis Sci 52(7):4324–4329

    Article  Google Scholar 

  • Koenig SB, Covert DJ, Dupps WJ Jr, Meisler DM (2007) Visual acuity, refractive error, and endothelial cell density six months after Descemet stripping and automated endothelial keratoplasty (DSAEK). Cornea 26(6):670–674

    Article  PubMed  Google Scholar 

  • Krabcova I, Studeny P, Jirsova K (2011) Endothelial cell density before and after the preparation of corneal lamellae for Descemet membrane endothelial keratoplasty with a stromal rim. Cornea 30(12):1436–1441

    Article  PubMed  Google Scholar 

  • Lie JT, Birbal R, Ham L, van der Wees J, Melles GR (2008) Donor tissue preparation for Descemet membrane endothelial keratoplasty. J Cataract Refract Surg 34(9):1578–1583

    Article  PubMed  Google Scholar 

  • McCauley MB, Price FW Jr, Price MO (2009) Descemet membrane automated endothelial keratoplasty: hybrid technique combining DSAEK stability with DMEK visual results. J Cataract Refract Surg 35(10):1659–1664

    Article  PubMed  Google Scholar 

  • McCauley MB, Price MO, Fairchild KM, Price DA, Price FW Jr (2011) Prospective study of visual outcomes and endothelial survival with Descemet membrane automated endothelial keratoplasty. Cornea 30(3):315–319

    Article  PubMed  Google Scholar 

  • Mehta JS, Chua J, Poh R, Beuerman RW, Tan D (2008) Primary graft failure after Descemet-stripping automated endothelial keratoplasty: clinico-pathological study. Cornea 27(6):722–726

    PubMed  Google Scholar 

  • Melles GR, Eggink FA, Lander F, Pels E, Rietveld FJ, Beekhuis WH, Binder PS (1998) A surgical technique for posterior lamellar keratoplasty. Cornea 17(6):618–626

    Article  PubMed  CAS  Google Scholar 

  • Melles GR, Lander F, Rietveld FJ (2002) Transplantation of Descemet’s membrane carrying viable endothelium through a small scleral incision. Cornea 21(4):415–418

    Article  PubMed  Google Scholar 

  • Melles GR, Ong TS, Ververs B, van der Wees J (2006) Descemet membrane endothelial keratoplasty (DMEK). Cornea 25(8):987–990

    Article  PubMed  Google Scholar 

  • Nejepinska J, Juklova K, Jirsova K (2010) Organ culture, but not hypothermic storage, facilitates the repair of the corneal endothelium following mechanical damage. Acta Ophthalmol 88(4):413–419

    PubMed  Google Scholar 

  • Ousley PJ, Terry MA (2005) Stability of vision, topography, and endothelial cell density from 1 year to 2 years after deep lamellar endothelial keratoplasty surgery. Ophthalmology 112(1):50–57

    Article  PubMed  Google Scholar 

  • Pels E, Rijneveld WJ (2009) Organ culture preservation for corneal tissue. Technical and quality aspects. Dev Ophthalmol 43:31–46

    Article  PubMed  CAS  Google Scholar 

  • Pereira Cda R, Guerra FP, Price FW Jr, Price MO (2011) Descemet’s membrane automated endothelial keratoplasty (DMAEK): visual outcomes and visual quality. Br J Ophthalmol 95(7):951–954

    Article  PubMed  Google Scholar 

  • Price FW Jr, Price MO (2005) Descemet’s stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg 21(4):339–345

    PubMed  Google Scholar 

  • Price MO, Fairchild KM, Price DA, Price FW Jr (2011) Descemet’s stripping endothelial keratoplasty five-year graft survival and endothelial cell loss. Ophthalmology 118(4):725–729

    Article  PubMed  Google Scholar 

  • Studeny P, Farkas A, Vokrojova M, Liskova P, Jirsova K (2010) Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S). Br J Ophthalmol 94(7):909–914

    Article  PubMed  Google Scholar 

  • Studeny P, Jirsova K, Kuchynka P, Liskova P (2012) Descemet membrane endothelial keratoplasty with a stromal rim in the treatment of posterior polymorphous corneal dystrophy. Indian J Ophthalmol 60(1):59–60

    Article  PubMed  Google Scholar 

  • Suwan-Apichon O, Reyes JM, Griffin NB, Barker J, Gore P, Chuck RS (2006) Microkeratome versus femtosecond laser predissection of corneal grafts for anterior and posterior lamellar keratoplasty. Cornea 25(8):966–968

    Article  PubMed  Google Scholar 

  • Terry MA, Ousley PJ (2005) Deep lamellar endothelial keratoplasty visual acuity, astigmatism, and endothelial survival in a large prospective series. Ophthalmology 112(9):1541–1548

    Article  PubMed  Google Scholar 

  • Zhu Z, Rife L, Yiu S, Trousdale MD, Wasilewski D, Siqueira A, Smith RE (2006) Technique for preparation of the corneal endothelium-Descemet membrane complex for transplantation. Cornea 25(6):705–708

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Czech Ministry of Education, Youth and Sports research project 0021620806/20610011. Institutional support was provided by PRVOUK-P24/LF1/3 program of the Charles University in Prague. IK was partially supported by the grant SVV-2012-264514 from the Charles University in Prague.

Conflict of interest

The authors report no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katerina Jirsova.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krabcova, I., Studeny, P. & Jirsova, K. Endothelial quality of pre-cut posterior corneal lamellae for Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S): two-year outcome of manual preparation in an ocular tissue bank. Cell Tissue Bank 14, 325–331 (2013). https://doi.org/10.1007/s10561-012-9327-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10561-012-9327-z

Keywords

Navigation