Viability of Intrastromal Endothelial-Descemet Membrane with Preserved Endothelium Polarity

Abstract

Purpose : To evaluate the viability of a healthy endothelial-Descemet membrane (EDM) graft after the insertion into a stromal pocket of a recipient donor cornea while preserving the polarity of the former

Methods : Research corneas [n=52] were divided into three groups: Group A, where an EDM (obtained from another cornea) with good endothelium was inserted in a stromal pocket endothelium side down; Group B, consisting of control corneas without EDM insertion; and Group C, pre-stripped membranes resting on their stroma used as a second control. The tissues were preserved in tissue culture medium for 21 days at 31°C. Parameters including viability of endothelial cells, expression of tight junction (ZO-1) and thickness were evaluated

Results : After 21 days, all the membranes inserted within the stromal pocket of Group A survived, although an average endothelial cell loss of 30.1% (±18.10) and a mortality of 10.2% (±22.86) were recorded. Qualitative analysis using triple staining with Hoechst, ethidium homodimer and calcein AM confirmed the mortality. ZO-1 was expressed where the cells were present, showing good integrity of tight junctions. Group C showed an average endothelial cell loss of 1.9% (±3.38), a mortality of 0.02% (±0.07) and a higher expression of ZO-1

Conclusions : An EDM graft with endothelium facing downwards can survive in a stromal pocket for at least 3 weeks, with an overall cell mortality of 30%. Further studies will be needed to evaluate the possible outcomes of the insertion of a healthy intrastromal EDMs in edematous corneas

This is a 2020 ARVO Annual Meeting abstract.