Evaluation of Efficacy, Efficiency, and Cell Viability of a Novel Descemet Membrane Endothelial Keratoplasty Graft Preparation Device, DescePrep, in Nondiabetic and Diabetic Human Donor Corneas.
Aged
Cell Count
Cell Survival
/ physiology
Corneal Diseases
/ surgery
Descemet Stripping Endothelial Keratoplasty
/ instrumentation
Diabetes Complications
/ surgery
Efficiency
Eye Banks
/ methods
Female
Humans
Male
Middle Aged
Slit Lamp Microscopy
Time Factors
Tissue Donors
Tissue and Organ Harvesting
/ methods
Treatment Outcome
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
01 Apr 2022
01 Apr 2022
Historique:
received:
22
04
2021
accepted:
09
07
2021
pubmed:
9
10
2021
medline:
12
3
2022
entrez:
8
10
2021
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the safety, efficacy, and efficiency of a Descemet membrane endothelial keratoplasty (DMEK) graft preparation device, DescePrep, through measurement of graft viability, yield, and preparation time in both healthy and diabetic (high-risk) donor eyes. Twenty nondiabetic and 10 diabetic donor corneas were processed using DescePrep, which standardizes the liquid bubble technique. Corneas were stained with trypan blue and then processed. Cell counts through specular microscopy, optical coherence tomography imaging, and slit-lamp analysis were used for the evaluation of graft separation and viability in 5 nondiabetic corneas. The remaining 25 corneas (15 nondiabetic and 10 diabetic) were evaluated for preparation success rate and processing time. Ten corneas (5 nondiabetic and 5 diabetic) were randomly selected for further evaluation of global cell loss through staining. Ninety-seven percent of corneas (29 of 30) were prepared successfully with DescePrep. The average preparation time was 2.83 ± 1.8 minutes. There was no significant difference in the time of preparation between the nondiabetic and diabetic groups (P = 0.077). The overall average cell death after processing was 7.9% ± 3.7% for all corneas. There was no significant difference in cell viability between diabetic and nondiabetic tissues after DescePrep processing (P = 0.769). DescePrep is a new DMEK preparation technique that can process both nondiabetic and diabetic donor corneas at high yields in minutes. High-yield preparation of diabetic corneas may offer eye banks access to a larger donor pool, which is important because the demand for DMEK grafts continues to rise worldwide.
Identifiants
pubmed: 34620764
doi: 10.1097/ICO.0000000000002861
pii: 00003226-202204000-00017
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
505-511Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
K. D. Solley, C. Diaz, B. T. Ostrander, E. Ruppel, A. Haileyesus, Y. Dou, S. Pramanik, and K. S. Parikh have ownership interest in Eyedea Medical, Inc. K. S. Parikh serves on the Board of Directors and owns company stock, which is subject to certain restrictions under Johns Hopkins University policy. The terms of this arrangement are being managed by Johns Hopkins University in accordance with its conflict-of-interest policies. The remaining authors have no conflicts of interest to disclose.
Références
Melles GR, Ong TS, Ververs B, et al. Descemet membrane endothelial keratoplasty (DMEK). Cornea. 2006;25:987–990.
Hos D, Matthaei M, Bock F, et al. Immune reactions after modern lamellar (DALK, DSAEK, DMEK) versus conventional penetrating corneal transplantation. Prog Retin Eye Res. 2019;73:100768.
Marques RE, Guerra PS, Sousa DC, et al. DMEK versus DSAEK for Fuchs' endothelial dystrophy: a meta-analysis. Eur J Ophthalmol. 2019;29:15–22.
Eye Bank Association of America. 2015 Eye Banking Statistical Report. Washington, DC: Eye Banking Association of America; 2015.
Eye Bank Association of America. 2019 Eye Banking Statistical Report. Washington, DC: Eye Banking Association of America; 2019.
Zafar S, Parker JS, De Kort C, et al. Perceived difficulties and barriers to uptake of Descemet's membrane endothelial keratoplasty among surgeons. Clin Ophthalmol. 2019;13:1055–1061.
Birbal RS, Sikder S, Lie JT, et al. Donor tissue preparation for DescemetDescemet membrane endothelial keratoplasty: an updated review. Cornea. 2018;37:128–135.
Ruzza A, Parekh M, Salvalaio G, et al. Bubble technique for Descemet membrane endothelial keratoplasty tissue preparation in an eye bank: air or liquid?. Acta Ophthalmol. 2015;93.
Parekh M, Ruzza A, Salvalaio G, et al. Descemet membrane endothelial keratoplasty tissue preparation from donor corneas using a standardized submerged hydro-separation method. Am J Ophthalmol. 2014;158:277–285.e1.
Tenkman LR, Price FW, Price MO. Descemet membrane endothelial keratoplasty donor preparation: navigating challenges and improving efficiency. Cornea. 2014;33:319–325.
Melles GR, Lander F, Rietveld FJ. Transplantation of Descemet's membrane carrying viable endothelium through a small scleral incision. Cornea. 2002;21:415–418.
Brissette A, Conlon R, Teichman JC, et al. Evaluation of a new technique for preparation of endothelial grafts for DescemetDescemet membrane endothelial keratoplasty. Cornea. 2015;34:557–559.
Ostrander BT, Solley K, Diaz C, et al. The state of Descemet membrane endothelial keratoplasty tissue processing: current practices and challenges. Eye Banking J. 2019;7:1–9.
Williams RS, Mayko ZM, Friend DJ, et al. Descemet membrane endothelial keratoplasty (DMEK) tissue preparation: a donor diabetes mellitus categorical risk stratification scale for assessing tissue suitability and reducing tissue loss. Cornea. 2016;35:927–931.
Greiner MA, Rixen JJ, Wagoner MD, et al. Diabetes mellitus increases risk of unsuccessful graft preparation in DescemetDescemet membrane endothelial keratoplasty: a multicenter study. Cornea. 2014;33:1129–1133.
Price MO, Lisek M, Feng MT, et al. Effect of donor and recipient diabetes status on Descemet membrane endothelial keratoplasty adherence and survival. Cornea. 2017;36:1184–1188.
Szurman P, Januschowski K, Rickmann A, et al. Novel liquid bubble dissection technique for DMEK lenticule preparation. Graefes Arch Clin Exp Ophthalmol. 2016;254:1819–1823.
Bhogal M, Balda MS, Matter K, et al. Global cell-by-cell evaluation of endothelial viability after two methods of graft preparation in Descemet membrane endothelial keratoplasty. Br J Ophthalmol. 2016;100:572–578.
Yazdi Y, Acharya S. A new model for graduate education and innovation in medical technology. Ann Biomed Eng. 2013;41:1822–1833.
Jardine GJ, Holiman JD, Stoeger CG, et al. Imaging and quantification of endothelial cell loss in eye bank prepared DMEK grafts using trainable segmentation software. Curr Eye Res. 2014;39:894–901.
Maharana P K, Sahay P, Singhal D, et al. Donor preparation in DescemetDescemet membrane endothelial keratoplasty. New Front Ophthalmol. 2019;5:1–6.
Tran KD, Alabi RO, Odell K, et al. Measuring endothelial cell loss on DMEK grafts after transplantation in human cadaveric whole eyes: description of the technique and pilot study. Cornea. 2018;37:1075–1080.
Bhogal M, Lwin CN, Seah XY, et al. Real-time assessment of corneal endothelial cell damage following graft preparation and donor insertion for DMEK. PLoS One. 2017;12:e0184824.
Muraine M, Gueudry J, He Z, et al. Novel technique for the preparation of corneal grafts for DescemetDescemet membrane endothelial keratoplasty. Am J Ophthalmol. 2013;156:851–859.