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Z. Zhu, L. Rife, S. Yiu, M.D. Trousdale, R.E. Smith; Evaluation of Human Endothelium–Descemet’s Membrane Preparation . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4527.
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Purpose: Replacing diseased corneal endothelium with a thin layer of Descemet’s membrane carrying intact functional endothelium may be a feasible method of treating corneal endothelium decompensation. To obtain a viable donor endothelium disc, we modified the Descemet’s membrane stripping technique and evaluated the effect on donor tissue preparation by computing the percentage of endothelial damage. Methods: Thirty–eight human corneas were mounted on an artificial anterior chamber, endothelial side up. Endothelium was stained with Alizarin red and examined under the microscope; photos were taken at five different sites (magnification: 10×). Using a Grieshaber microsurgical knife and Kelman–McPherson forceps, we obtained 6– x 7–mm rectangular pieces of endothelium–Descemet’s membrane complex, and the pieces were transferred on a slide, endothelium side up. Photos of endothelium were again taken at five different sites under the same magnification. Digital photos were analyzed and the approximate percentage of endothelial damage was calculated. Harvested samples were processed for H&E staining. Results: Thirty–three of 38 endothelium–Descemet’s preparations were complete peels with minimal endothelial damage (less than 5%). Five of 38 preparations were either incomplete with tears or had a higher percentage of endothelial damage, i.e. greater than 10%. H&E–stained random sections showed the presence of endothelium with intact Descemet’s membrane and no stromal tissue. Conclusions:We modified the technique of Melles and were able to obtain a sheet of Descemet’s membrane and endothelium with minimal damage to the endothelium and with no remaining stroma. Using this simple technique, the endothelium–Descemet’s membrane complex can be obtained in minutes. This technique may be useful for corneal endothelium transplantation.
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