Novel technique for the preparation of corneal grafts for descemet membrane endothelial keratoplasty.
Am J Ophthalmol
; 156(5): 851-9, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-23932263
ABSTRACT
PURPOSE:
To report a simple novel technique to facilitate preparation of Descemet membrane grafts for Descemet membrane endothelial keratoplasty (DMEK).DESIGN:
Laboratory investigation and retrospective, single-center, consecutive case series.METHODS:
Preparation of the endothelial graft is performed on an artificial anterior chamber, endothelial side up. After an incomplete circular superficial trephination, we describe a simple technique using a 27 gauge cannula to detach the Descemet membrane (DM). Endothelial cell density (ECD) was measured before dissection on 12 human corneas for research and 3 days after storage in organ culture. Histologic and electron microscopy analysis were performed. A DMEK was performed in 50 patients with Fuchs dystrophy. Visual acuity and ECD were evaluated 2 and 6 months after surgery.RESULTS:
ECD was 2765 ± 256 cells/mm(2) on corneas for research before dissection and 2651 ± 305 cells/mm(2) after 3 days in organ culture (P < .01). Histologic and electronic sections confirm that the cleavage was between DM and posterior stroma. Clinically, preparation of 2 corneas from a single donor was unsuccessful; 48 corneas were clear at 2 months and 47 at 6 months. At 2 months 77% of the patients had recovered a visual acuity of at least 20/30. At 6 months, 91.5% of the patients had a visual acuity of at least 20/30. ECD was 2656 ± 28 cells/mm(2) (range 2450-3100 cells/mm(2)) preoperatively, 1797 ± 41 cells/mm(2) (range 1100-2700 cells/mm(2)) at 2 months, and 1658 ± 43 cells/mm(2) (range 900-2600 cells/mm(2)) at 6 months.CONCLUSION:
We report here a reliable and efficient technique for the preparation of pure Descemet membrane grafts.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Manejo de Espécimes
/
Distrofia Endotelial de Fuchs
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Coleta de Tecidos e Órgãos
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Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
Tipo de estudo:
Observational_studies
Limite:
Aged
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Ophthalmol
Ano de publicação:
2013
Tipo de documento:
Article