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S. D. Chang; A New Method of Harvesting Descemet’s Membrane-Endothelium Complex for DMEK: Experimental Animal Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1961. doi: https://doi.org/.
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To report a new method of harvesting Descemet’s membrane-endothelium complex in order to perform Descemet’s membrane-endothelial keratoplasty using synthetic carrier, experimental rabbit eye model.
Enucleated eyeballs of rabbit were incised along near equatorial area circumferential 360°, after then, manual separation between sclera and underlying connective tissue from suprachoroidal space in direction to central cornea step by step in spiral pattern. After complete separating the stroma from the complex, Descemet’s membrane-endothelium-iris complex was excised from the globe around outside of trabecular meshwork. Synthetic carrier (soft contact lens) lay down on punch block, excised complex ride over carrier with endothelium-iris side upward. 1st punch of 1mm larger size than designed graft performed, after then remove the excised tissue including iris over endothelium. After spreading Descemet’s membrane-endothelium complex over carrier and punch block, 2nd punch of designed graft size was performed. Harvested Descemet’s membrane-endothelium complex riding on synthetic carrier, were evaluated through vital stain (Alizarin-reds, trypan blue stain), complex was photographed on microscope for calculation of endothelial cell loss rate.
Overall cell loss rate is 1.83 ± 2.34%, ranged from 0 to 8.59%. We found 1 forceps marking with cell loss at the edge of grasping point. Harvested complex riding on carrier safely inserted into modified injector system under protection of carrier.
This new method of enblock harvesting Descemet’s membrane-endothelium complex approaching from suprachoroidal space provide minimal damage of endothelium during harvesting, carrying to injector and pass through injector. However further human eye bank eye study would by needed.
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