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N. Shamie, A. K. Shah, D. Davis-Boozer, D. Friend, M. A. Terry; The Effect of Cold Storage on Endothelial Cell Loss After Dmek Donor Preparation Using the "Big Bubble" Technique. Invest. Ophthalmol. Vis. Sci. 2009;50(13):617.
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To evaluate the effects of Optisol GS storage media on endothelial cell counts after preparing DMEK donor tissue using the "Big Bubble" technique.
A surgeon experienced in lamellar surgical techniques prepared 8.0 mm diameter DMEK discs using the "Big Bubble" technique by utilizing a 27G needle to inject air beneath the endothelium of donor corneas placed on Barron suction trephines endothelial side up (n=10). A total of 8 donor bank eyes were used as practice before commencing the experiment. Endothelial cell density (ECD) was determined via specular microscopy for 5 of the grafts both immediately following the big bubble and again after 24 hours cold storage in Optisol GS (5 grafts were too edematous to obtain specular images). ECDs were compared using a paired student’s t-test. Using a previously described method of vital dye staining and computer digitized planimetry, endothelial cell damage was evaluated after 24 hours cold storage.
Mean ECDs were not significantly different between time points. Mean ECD was 2256 immediately following the procedure and 2201 after cold storage; p=0.6. Change in ECD ranged from 11% loss to 20% gain. Vital dye staining on tissues revealed a mean cell loss of 14% (range 5.3% - 35.6%) due to stripping and 24 hours of cold storage.
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