Descemet’s membrane graft separation at Barcelona tissue bank: technique description, safety, and efficacy analysis through clinical follow-up

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:00

Venue: Room A3, Podium 3

First Author: : N.Otero Areitio SPAIN

Co Author(s): :    A. Vilarrodona   E. Agusti   J. Peraza   O. Gris   R. Casaroli-Marano   E. Trias     

Abstract Details

Purpose:

To describe the procedure for graft harvesting and transporting for Descemet membrane endothelial keratoplasty (DMEK). This method assures an excellent endothelial cell counting after stripping and sufficient tissue for a target diameter trephination. In order to validate the process, we analyze the security and the efficacy of the transplanted endothelial graft .

Setting:

Barcelona Tissue Bank, Hospital Clinic de Barcelona, Hospital Bellvitge and Instituto de Microcirugía Ocular

Methods:

Adapted SCUBA harvesting method for cultured corneas were performed. From September 2016 to March of 2018, 147 grafts for DMEK were obtained and transplanted. We analyze the following parameters in the first 76 implants: Endothelial cell density before surgery, surgery related factors (type of injector, unfolding time, air or gas tamponade, immediate postoperative graft attachment status, needing of rebubbling), perception of quality of tissue reported by surgeons and one month postoperative clinical follow-up feedback sheet.

Results:

Mean endothelial cell density after stripping was 2669 ±148, fully attached graft was observed in 55 cases post-operatively. Partial peripheral or central detachment were present in 22.3% and 5.3% of the cases, respectively. The final surgeon perception about the quality of the tissue was reported as excellent in 44.7% of the cases, good in 50% of the cases, average in 5.3% of the cases. After one month of DMEK surgery, none unsatisfactory events were reported in 31 feedback forms that were received at Barcelona Tissue Bank.

Conclusions:

The tissue preparation by adapted SCUBA method from cultured corneas preserved in deturgescent medium proved to be secure and effective and allowed to choose the target diameter. The endothelial cell density after graft preparation was similar to previous evaluations. The short-term on-line questionnaire form showed an initial successful surgery rate of 90% of the cases. One month follow-up is useful to assure safety and efficacy as regards the tissue implanted. We found no satisfactory evolution in 10% of the cases which not seem to be related to the quality and safety of issued tissue.

Financial Disclosure:

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