scholarly journals Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

10.3791/51919 ◽  
2014 ◽  
Author(s):  
Hassan N. Tausif ◽  
Lauren Johnson ◽  
Michael Titus ◽  
Kyle Mavin ◽  
Navasuja Chandrasekaran ◽  
...  
Keyword(s):  
Tissue Preparation ◽  
Endothelial Keratoplasty ◽  
Donor Tissue ◽  
Descemet’S Membrane Endothelial Keratoplasty ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Corneal Donor ◽  
Corneal Donor Tissue

Pre-Descemet’s endothelial keratoplasty: a simple, Descemet’s membrane scoring technique for successful graft preparation

2021 ◽  
pp. bjophthalmol-2020-317613
Author(s):  
Nicolas Cesario Pereira ◽  
Adriana dos Santos Forseto ◽  
Rafaela Cesario Pereira Maluf ◽  
Harminder Singh Dua
Keyword(s):  
Standard Technique ◽  
Tissue Preparation ◽  
Endothelial Keratoplasty ◽  
Donor Tissue ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Group 2 ◽  
Group 1

PurposePre-Descemet’s endothelial keratoplasty (PDEK) donor tissue preparation involves the intrastromal injection of air to create a type 1 big bubble (BB) and avoidance of the creation of a type 2 BB. The purpose of this study was to design and test a technique to consistently creates a type 1 BB without risk of creating a type 2 BB.MethodsA prospective matched study with 64 human donor sclerocorneal discs, which were not suitable for corneal transplantation, was conducted. The corneas were divided into two groups, of which 32 were subjected to the standard technique of preparing the PDEK donor tissue (group 1, control) and 32 new technique, where in the donor Descemet’s membrane was scored with a Sinskey hook. Frequency of occurrence of different types of BB was compared and statistically analysed.ResultsWith the standard technique (group 1), type 1 BB occurred in 53.1%, type 2 BB in 34.4% and mixed BB in 12.5% of samples. With the scoring technique (group 2), a type 1 BB occurred in 100% of the samples. No type 2 or mixed BB occurred in any case in group 2. The difference in creation of a type 1BB between the two groups was statistically significant (p=0.00).ConclusionThe scoring technique is a simple, inexpensive and reproducible option to consistently achieve a type 1 BB to prepare PDEK graft tissue. The next step would be to study the clinical outcomes of PDEK performed with tissue obtained by the scoring technique.

scholarly journals Development of a Donor Tissue Holding Technique for Descemet’s Membrane Endothelial Keratoplasty Using a 25-Gauge Graft Manipulator

2018 ◽  
Vol 9 (3) ◽  
pp. 431-438 ◽  
Author(s):  
Akira Kobayashi ◽  
Hideaki Yokogawa ◽  
Natsuko Mori ◽  
Toshinori Masaki ◽  
Kazuhisa Sugiyama
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Postoperative Complications ◽  
Endothelial Keratoplasty ◽  
Donor Tissue ◽  
Corrected Visual Acuity ◽  
Descemet’S Membrane Endothelial Keratoplasty ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Reproducible Manner

Purpose: To report a modified surgical technique called the “donor tissue holding technique for Descemet’s membrane endothelial keratoplasty (DMEK)” using a newly developed 25-gauge graft manipulator. Methods: Six consecutive patients exhibiting endothelial dysfunction were enrolled and treated by DMEK. In brief, after insertion of a DMEK donor into the anterior chamber, the edge of the roll was grasped using a graft manipulator and this grasp was maintained throughout the centering and opening of the roll (holding technique). The following parameters were evaluated in comparison to the previous 10 consecutive DMEK cases in which the no touch technique was used: time of graft unfolding, incidence of intra-/postoperative complications, and best spectacle-corrected visual acuity (BCVA) and endothelial cell density (ECD) 6 months after the procedure. Results: In both technique groups, neither intra- nor postoperative complications were noted in any case. No differences were observed between the two groups in postoperative BCVA (p = 0.88). Also, no differences were observed between the two groups in postoperative ECD (holding technique group: 2,108.3 cells/mm2, no touch technique group: 1,491.7 cells/mm2) (p = 0.08) Most notably, the time of graft unfolding prior to filling with air was significantly reduced in the holding technique group (305.5 s) compared to that of the no touch technique group (1,310.0 s; p = 0.01). Conclusions: This donor tissue holding technique enabled rapid and safe DMEK in a reproducible manner, even in Asian eyes with shallow anterior chambers with high vitreous pressure.

scholarly journals Corneal pachymetry by AS-OCT after Descemet’s membrane endothelial keratoplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Friso G. Heslinga ◽  
Ruben T. Lucassen ◽  
Myrthe A. van den Berg ◽  
Luuk van der Hoek ◽  
Josien P. W. Pluim ◽  
...  
Keyword(s):  
Deep Learning ◽  
Endothelial Function ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anatomical Landmarks ◽  
Endothelial Keratoplasty ◽  
Descemet’S Membrane Endothelial Keratoplasty ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Thickness Measurements

AbstractCorneal thickness (pachymetry) maps can be used to monitor restoration of corneal endothelial function, for example after Descemet’s membrane endothelial keratoplasty (DMEK). Automated delineation of the corneal interfaces in anterior segment optical coherence tomography (AS-OCT) can be challenging for corneas that are irregularly shaped due to pathology, or as a consequence of surgery, leading to incorrect thickness measurements. In this research, deep learning is used to automatically delineate the corneal interfaces and measure corneal thickness with high accuracy in post-DMEK AS-OCT B-scans. Three different deep learning strategies were developed based on 960 B-scans from 50 patients. On an independent test set of 320 B-scans, corneal thickness could be measured with an error of 13.98 to 15.50 μm for the central 9 mm range, which is less than 3% of the average corneal thickness. The accurate thickness measurements were used to construct detailed pachymetry maps. Moreover, follow-up scans could be registered based on anatomical landmarks to obtain differential pachymetry maps. These maps may enable a more comprehensive understanding of the restoration of the endothelial function after DMEK, where thickness often varies throughout different regions of the cornea, and subsequently contribute to a standardized postoperative regime.

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