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Mark Terry, Michael Straiko, Julia Talajic, David Davis-Boozer; Descemet’s Membrane Endothelial Keratoplasty (DMEK): Early results using eye bank prepared, pre-stripped donor tissue in the first 43 cases. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3094.
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To compare the postoperative complication rates of DMEK using pre-stripped tissue to the results from initial published DMEK series using surgeon prepared tissue.
43 DMEK cases were performed for Fuchs’ dystrophy eyes using the Yoeruek tap technique. Donors had been pre-stripped by the eye bank 1 to 2 days prior to surgery. The incidence of graft replacement and frequency of re-bubbling was recorded and compared to published rates for similar cohorts.
There were 3 DMEK grafts (7%) that were replaced, all due to non-attachment. There were 17 eyes (40%) that were re-bubbled, with 16 successfully re-bubbled eyes quickly attaining clear corneas and good vision, and 1 eye in the replacement group. Published DMEK series by Melles, Price, and Kruse of their initial 50 or more cases with surgeon prepared tissue have shown graft failure rates of 8% to 20% and re-bubble rates of 50% to 92%.
This is the first report of clinical results using donor tissue pre-stripped by technicians in the U.S. for DMEK surgery. Donors that are pre-stripped by the eye bank for DMEK surgery do not increase the risk of graft failure or re-bubbling compared to surgeon prepared tissue. Pre-stripped tissue transfers the financial risk of donor damage and case cancellation from the surgeon to the eye bank, removing one large obstacle to the adoption by surgeons of DMEK surgery.
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