September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Do specular images of endothelial cell density post DMEK preparation tell you anything new?
Author Affiliations & Notes
  • Christopher Stoeger
    Lions VisionGift, Portland, Oregon, United States
  • Beth Ann Benetz
    Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio, United States
    UH Eye Institute, Cleveland, Ohio, United States
  • Zachary Mayko
    Lions VisionGift, Portland, Oregon, United States
  • Harry Menegay
    Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio, United States
    UH Eye Institute, Cleveland, Ohio, United States
  • Chris Donovan
    Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio, United States
    UH Eye Institute, Cleveland, Ohio, United States
  • Mark A Terry
    Cornea, Devers Eye Institute, Portland, Oregon, United States
  • Jonathan H Lass
    Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio, United States
    UH Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Christopher Stoeger, None; Beth Ann Benetz, None; Zachary Mayko, None; Harry Menegay, None; Chris Donovan, None; Mark Terry, None; Jonathan Lass, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1935. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Christopher Stoeger, Beth Ann Benetz, Zachary Mayko, Harry Menegay, Chris Donovan, Mark A Terry, Jonathan H Lass; Do specular images of endothelial cell density post DMEK preparation tell you anything new?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1935.

      Download citation file:


      © 2017 Association for Research in Vision and Ophthalmology.

      ×
  • Supplements
Abstract

Purpose : To compare a single eye bank’s measurement of endothelial cell density (ECD) of Descemet Membrane Endothelial Keratoplasty (DMEK) grafts before and after preparation using two separate counting methods.

Methods : A series of sixty donor tissues were prepared for DMEK surgery. Two to four specular microscoic images of the central endothelium were taken both before and after preparation and ECDs evaluated for a total of 345 unique images. An eye bank technician analyzed each image using a center dot (CD) method and then averaged those values. Images were then masked and provided to the Cornea Image Analysis Reading Center (CIARC) for independent analysis by certified readers using the HAI variable frame (VF) method and a dual grading and adjudication process.

Results : Average ECD was 2678 ± 259 cells/mm2 before preparation when measured by CD method. Final ECD was 2599 ± 280 cells/mm2 measured by the VF method (p<0.001, n=176). After preparation the ECD was 2719 ± 265 cells/mm2 using the CD method and 2615 ± 344 cells/mm2 using the VF method (p<0.001, n=169). The difference in ECD before and after DMEK preparation was not found to be statistically significant when evaluated using the CD method (p=0.19). The difference before and after DMEK preparation also was not found to be statistically significant when evaluated using the VF method (p=0.64). After DMEK preparation 80% (48/60) of post-preparation ECD values fell within a range of ± 300 cells/mm2 using the CD method and 82%(49/60) fell within this range using the VF method.

Conclusions : Our results show consistent measures of ECD before and after DMEK preparation. We did not find a statistically significant difference between ECD values before and after DMEK preparation when comparing within each method (CD or the VF method). While we did find statistically significant differences when evaluating endothelial images between methods we feel they are not clinically significant. Most eye banks when releasing donor tissue for keratoplasty do not rely on a single image and cell count, but an average of several images and ECDs to account for natural variation in ECD along Descemet membrane. In this study, post-prep image quality was diminished after DMEK preparation compared to the pre-preparation images and may have contributed to the non-significant ECD increase. More accurate results may be observed in future studies with improved image quality.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×