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J. J. Ma, P. Y. H. Wong; Evaluation of Techniques for Endothelial Donor Preparation in DMEK. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2187.
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To evaluate the efficacy of described methods for the endothelial donor preparation of isolated Descemet’s membrane (DM) and endothelium from human corneas preserved in Optisol.
Five known techniques and their variants were used to prepare endothelial donors from human corneas. Two techniques involving pneumo-dissection of Descemet’s membrane from the corneal stroma utilizing an air bubble were found to be the most easily reproducible, handled and stored. 20 human corneas preserved in Optisol were randomly assigned to these two techniques for pneumo-dissection, group A (utilizing positive pressure) and group B (without pressure).
A stromal-DM interface (SDMI) air bubble was achieved in 7/10 corneas in group A. A SDMI bubble was achieved in 9/10 human corneas in group B. Repeat air injections were often necessary to achieve adequate dissection using a needle reinserted bevelled up. After storage in Optisol for 1 week, cell counts revealed minimal endothelial cell losses in both groups A and B.
A modified bubble technique was the most consistent method for isolating Descemet's membrane for endothelial donor preparation in our series with group B > group A. This may be a useful technique for donor preparation in DMEK surgery utilizing corneas preserved in Optisol.
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