Donor tissue preparation for Descemet membrane endothelial keratoplasty

J Cataract Refract Surg. 2008 Sep;34(9):1578-83. doi: 10.1016/j.jcrs.2008.05.036.


Purpose: To evaluate a technique for preparing a donor Descemet membrane carrying autologous endothelium for transplantation in Descemet membrane endothelial keratoplasty (DMEK).

Setting: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.

Methods: A 9.5 mm diameter DM carrying autologous endothelium was stripped from 10 corneoscleral rims that had been organ cultured for 1 week. The endothelial cell density (ECD) was evaluated with light microscopy before and immediately after DM was stripped and during 4 additional weeks of organ culture.

Results: The mean ECD was 2701 cells/mm(2) +/- 302 (SD) before and 2719 +/- 322 cells/mm(2) immediately after DM was stripped and declined from 2604 +/- 352 cells/mm(2) after 1 week to 2190 +/- 768 cells/mm(2) after an additional 4 weeks of organ culture (n = 10). Typical "endothelial streaks," ie, linear cellular disruptions observed immediately after DM was stripped, showed complete regeneration after the second culture period.

Conclusions: Descemet grafts for transplantation in DMEK procedures can be surgically prepared from organ-cultured corneal rims and stored for an additional 3 weeks with acceptable endothelial cell loss. Because the donor tissue can be dissected directly from organ-cultured corneoscleral rims, donor preparation for DMEK can be readily accessible to most corneal surgeons.

MeSH terms

  • Adult
  • Aged
  • Cell Count
  • Corneal Diseases / surgery
  • Corneal Transplantation*
  • Descemet Membrane / surgery*
  • Endothelium, Corneal / pathology
  • Endothelium, Corneal / transplantation*
  • Humans
  • Middle Aged
  • Organ Culture Techniques / methods
  • Specimen Handling / methods*
  • Tissue Donors*