Punching DMEK graft on a contact lens vs punching the graft on the donor stroma: preserving more endothelial cells at the graft margin

Session Details

Session Title: Presented Poster Session: Surgical Cornea

Venue: Poster Village: Pod 2

First Author: : Y.Nahum ISRAEL

Co Author(s): :    A. Achiron   I. Bahar   E. Livny                 

Abstract Details

Purpose:

To evaluate whether punching a Descemet membrane endothelial keratoplasty (DMEK) corneal grafts on a scaffold contact lens reduces endothelial cells loss at the graft margin, compared to punching the graft on the donor stroma.

Setting:

Rabin Medical Center

Methods:

DMEK grafts were prepared using 2 different conditions: punching the graft on contact lens or punching on the donor stroma following its peeling from the stroma. The tissues samples were evaluated for size of Descemet's membrane denuded areas at 4 points at the graft margin. We included 6 pairs of corneas from 3 donors (mean age 66.3±5.1

Results:

Grafts that were prepared using contact lens as a scaffold had less Descemet's membrane area denuded of endothelial cells than grafts that were punched directly on the donor stroma  (total area of Descemet denuded area: 0.06±0.08 mm2 vs 1.17±0.02 mm2, p=0.018) This was calculated to represents 2% more endothelial cells available for transplantation. Estimating a 7.0% reduction in endothelial cell count a year post DMEK, punching a graft on a scaffold contact lens might yield a 0.5-year difference in graft survival. Graft preparation time did not significantly differ between the methods (6.4±0.49 vs 9.8±3.7 minutes, p=0.46).

Conclusions:

Punching a DMEK grafts on a contact lens preserves more endothelial cells available for transplantation than punching the graft on the donor stroma, which may lead to longer graft survival

Financial Disclosure:

None