Abstract
Purpose :
Descemet membrane endothelial keratoplasty (DMEK) may provide superior results when compared to Descemet stripping automated endothelial keratoplasty (DSAEK). Technical challenges associated with DMEK may be reduced by advanced preparation methods utilized by eye banks including short-term storage (up to 24 hours) of pre-stripped, pre-stained, and pre-loaded grafts (P3 DMEK) which have been shown to be safe. The purpose of this study was to determine the safety of long-term storage and shipping of pre-loaded DMEK grafts.
Methods :
A total of 27 cadaveric corneas were prepared per standard protocol using modified Jones tube injectors as P3 DMEK. The corneas were masked to groups that were prepared <9 hours (control), 48 hours, and 72 hours prior to unloading and analysis. The 48 and 72 hour tissues were shipped by airfreight on each day prior to arrival to simulate domestic and international shipping. The corneas were then stained using Calcein AM vital dye and imaged using an inverted confocal microscope. ECL was quantified using MetaMorph software.
Results :
ECL for the control, 48 and 72 hour groups were 25.5% ±9.2%, 18.1% ±7.4%, and 21.45% ±11.81%, respectively (figure 1). A one-way ANOVA test was conducted which found no statistical difference in ECL between the three groups. Three grafts were removed from statistical analysis due difficulty with unloading prior to ECL being calculated.
Conclusions :
Endothelial cell loss in P3 DMEK tissue prepared 48 and 72 hours in advance and shipped using standard methods is similar to P3 DMEK prepared on the same day. These findings support the safety of domestic and international shipping of P3 DMEK grafts.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.