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Theofilos Tourtas, Julia M Weller, Bjoern O Bachmann, Kathrin Roessler, Ursula Schlotzer-Schrehardt, Friedrich E Kruse; Factors determining the scroll formation of the graft for Descemet membrane endothelial keratoplasty (DMEK). Invest. Ophthalmol. Vis. Sci. 2014;55(13):880.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the factors determining the scroll formation of the graft during graft preparation for Descemet membrane endothelial keratoplasty (DMEK) surgery.
Retrospective, consecutive case series of 74 grafts prepared from organ-cultured corneoscleral buttons for DMEK surgery. The DMEK grafts were divided into 3 groups based on the diameter of the lumen of the graft after successful stripping in relation to the diameter of the lumen of the injector cartridge. In group A (n=27) the diameter of the graft's lumen was larger than the diameter of the lumen of the injector cartridge. In group B (n=21) the diameters of the lumen of the graft and the injector cartridge were equal. In group C (n=26) the diameter of the graft's lumen was smaller than those of the injector cartridge. Mean outcome measures included donor age, thickness of the residual endothelial cell-Descemet's membrane-complex (EDM) obtained after graft preparation, storage duration and donor endothelial cell density (dECD).
All graft preparations were uneventful. Mean donor age was significantly higher in group A (82.7 ± 8.4 years) than in group B (77.4 ± 4.9 years) (P=0.003) and significantly higher in group B than in group C (66.7 ± 6.9 years) (P<0.001). Mean EDM thickness was 15.11 ± 2.32 µm in group A, 13.52 ± 1.55 µm in group B and 12.70 ± 1.82 µm in group C. Difference in EDM thickness was statistically significant between groups A and B (P=0.005) and not statistically significant between groups B and C (P=0.104). Differences in storage duration and dECD were not statistically significant between groups A and B (P=0.635 and P=0.394, respectively) as well as between groups B and C (P=0.197 and P=0.136, respectively).
The strongest factor determining the scroll formation of the DMEK graft was the donor age which is related with the EDM thickness after graft preparation.
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