DMEK lenticule preparation from donor corneas using a novel ‘SubHyS’ technique followed by anterior corneal dissection

Abstract

The DEGs can be preserved in a deturgescent medium for up to 7 days. The procedure provides a standardised, pre-validated (quality assured), pre-separated, no-touch, ready-to-use tissue and also reduces the preparation time. Further, the tissues can be trephined as per the surgeon's convenience and can either be rolled or a contact lens could be used for final delivery of the DEG using a surgical glide.

Descemet membrane endothelial keratoplasty

“…However, variability and failure to obtain a ‘big bubble’ remains an issue, with reports of up to 83% EC loss, and many donors with a significant layer of remaining stroma attached to the DM 32. More recently, a technique has been described using injection of organ culture storage medium to cleave the DM-stromal plane while the donor is still submerged 33 34. Essentially, donor corneas were submerged in tissue culture medium while a 25-gauge needle was inserted bevel up, beneath the trabecular meshwork into the stroma and injected with storage medium to create a liquid bubble, before the bubble is removed and the donor is trephined to size.…”

Novel liquid bubble dissection technique for DMEK lenticule preparation

“…Many new dissection techniques have been described in the recent past with the goal of less harmful preparation while yielding a more effective time and tissue management [4][5][6][7][8][9][10].…”

“…Therefore, a focus of recent investigations was put on Descemet's membrane (DM) dissection techniques [4][5][6][7][8][9][10]. Salvaio and colleagues reported about a novel 'SubHyS' technique for DMEK lenticule preparation [10].…”

“…Salvaio and colleagues reported about a novel 'SubHyS' technique for DMEK lenticule preparation [10]. It seems to be accurate and safe, but also elaborate.…”

Organ culture storage of pre-prepared corneal donor material for Descemet's membrane endothelial keratoplasty

“…25 26 To our knowledge, no systematic comparison of global EC viability for these different storage techniques has been conducted, with most published studies reporting results of ECD changes in small high power fields. [26][27][28] We previously described a technique to map the viability of every cell in DMEK transplants that fully account for graft curvature, wound healing, any proliferation and ongoing cell loss. 14 We used this method to show that a peel technique was superior to a fluid bubble method in terms of endothelial viability for tissue prepared immediately prior to use.…”