June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Analysis of a novel delivery method of eye bank prepared fully peeled endothelial DMEK tissue
Author Affiliations & Notes
  • Hussain Elhalis
    Ophthalmology, University of Florida, Gainesville, FL
  • Mitchell D McCartney
    Lions Eye Institute for Transplant and Research, Tampa, FL
  • Nicholas Sprehe
    Lions Eye Institute for Transplant and Research, Tampa, FL
  • Alexander Blandford
    Ophthalmology, University of Florida, Gainesville, FL
  • Matthew Gray
    Ophthalmology, University of Florida, Gainesville, FL
  • Lynn Forest-Smith
    Lions Eye Institute for Transplant and Research, Tampa, FL
  • Patrick Gore
    Lions Eye Institute for Transplant and Research, Tampa, FL
  • Anup Kubal
    Ophthalmology, University of Florida, Gainesville, FL
  • Footnotes
    Commercial Relationships Hussain Elhalis, None; Mitchell McCartney, None; Nicholas Sprehe, None; Alexander Blandford, None; Matthew Gray, None; Lynn Forest-Smith, None; Patrick Gore, None; Anup Kubal, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1581. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Hussain Elhalis, Mitchell D McCartney, Nicholas Sprehe, Alexander Blandford, Matthew Gray, Lynn Forest-Smith, Patrick Gore, Anup Kubal; Analysis of a novel delivery method of eye bank prepared fully peeled endothelial DMEK tissue. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1581. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

Surgeon preparation of corneal tissue for Descemet membrane endothelial keratoplasty (DMEK) has contributed to its slow adoption. Currently, eye banks are providing only partially peeled Descemet's membrane (DM), thereby not entirely eliminating risk of intraoperative tissue loss. We investigate the viability of fully peeled free floating eye bank endothelial tissue and demonstrate the use of a modified technique for cell count analysis of endothelial tissue scrolls.

 
Methods
 

Donor corneas not suitable for transplant for reasons such as sepsis and low endothelial cell counts were randomly assigned to the three groups (n=5). Group 1 (control) DM were partially peeled and placed in Optisol GS (B&L) in a viewing chamber (Krolman); Group 2 DM were partially peeled and placed in Optisol GS in a viewing chamber then packed for shipping and transported. Group 3 DM were completely peeled after trephination and placed free-floating in a bottle of Optisol-GS. The bottles were also packed for shipping and transported. Endothelial cell density (ECD) was obtained from all groups with a specular microscope before tissue preparation as well as immediately after performing a partial DM peel. Additionally, ECD was assessed using a modification of Park et al. (2012) staining technique on day 0 in group 1 and after 24 hours for group 2 and 3 to simulate time elapsed from eye bank preparation to intraoperative use.

 
Results
 

Measurements of ECD were successfully obtained in all 15 donor corneas. The mean ECD in Group 1 pre-peel and post-peel was 2356 cell/mm2 ± 267 (SD) and 2507 cell/mm2 ± 208, respectively. For Group 2, the mean ECD pre-peel and 24 hours post partial peel with transport was 2369 cell/mm2 ± 308 (SD) and 3132 cell/mm2 ± 625 (SD), respectively. For Group 3, the mean ECD pre-peel and 24 hours free floating with transport was 2271 cell/mm2 ± 309 (SD) and 2304 cell/mm2 ± 793 (SD), respectively. The differences in ECD within the groups were not statistically significant.

 
Conclusions
 

This proof of concept study shows that eye bank prepared and free floating donor tissue for use in DMEK appears to be a reasonable option based on the preservation of ECD. Future studies will explore further protection of fully peeled grafts with use of pre-loading devices.  

 

 
×
×

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.

×