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BMJ Open Ophthalmol
BMJ Open Ophthalmol
bmjophth
bmjophth
BMJ Open Ophthalmology
2397-3269
BMJ Group BMA House, Tavistock Square, London, WC1H 9JR

37282697
bmjophth-2022-EEBA.24
10.1136/bmjophth-2022-EEBA.24
Oral abstracts
Theme 4 – New paradigms in eye banking
1506
24 Effect of graft preparation techniques on clinical outcomes after Descemet membrane endothelial keratoplasty (DMEK)
Lie Jessica T 12
Beek Esther AGroeneveld-van 12
Oellerich Silke 1
Sajet Anita 12
Kok Jet 12
Dedeci Methap 12
de Jong Maloeke 12
Melles Gerrit RJ 123
Kocaba Viridiana 123
van der Wees Jacqueline 12
1 NIIOS, Rotterdam, Netherlands
2 Amnitrans Eye Bank Rotterdam,, Netherlands
3 Melles Cornea Clinic Rotterdam,, Netherlands
2022
16 11 2022
7 Suppl 2 Abstracts of the European Eye Bank Association Virtual Meeting, 3–5 March 2022 A10A11
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
2022
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

Purpose

To compare the clinical outcomes after Descemet membrane endothelial keratoplasty (DMEK) for grafts prepared by the manual no-touch peeling technique and grafts prepared by a modified liquid bubble technique.

Material and Methods

For this study, 236 DMEK grafts were included that were prepared at Amnitrans EyeBank Rotterdam by experienced eye bank personnel. 132 grafts were prepared by using the ‘no-touch’ DMEK preparation technique and 104 grafts by using a modified liquid bubble technique. The liquid bubble technique was modified to render it a no-touch technique while maintaining the ability to save the anterior donor button as a potential Deep Anterior lamellar keratoplasty (DALK) or Bowman layer (BL) graft. DMEK surgeries were performed at Melles Cornea Clinic Rotterdam by experienced DMEK surgeons. All patients underwent DMEK for Fuchs endothelial dystrophy. Average patient age was 68 (±10) years and average donor age was 69 (±9) years with no difference between the two groups. Endothelial cell density (ECD) was evaluated after graft preparation by light microscopy in the eye bank and at 6-month postoperatively by specular microscopy.

Results

Endothelial cell density (ECD) decreased from 2705 (±146) cells/mm2 (n=132) before to 1570 (±490) cells/mm2 (n=130) at 6 months postoperatively for grafts prepared by the no-touch technique. For grafts prepared by the modifiedliquid bubble technique, ECD decreased from 2627 (±181) cells/mm2 (n=104) before to 1553 (±513) cells/mm2 (n=103) after surgery. Postoperative ECD did not differ for grafts prepared by the two techniques (P=0.79). Central corneal thickness (CCT) decreased from 660 (±124) µm to 513 (±36) µm postoperatively in the no-touch group and from 684 (±116) µm to 515 (±35) µm postoperatively in the modified liquid bubble group, with no postoperative CCT difference between groups (P=0.59). In total 3 eyes underwent re-surgery within the study period (n=2 (1.5%) in the no-touch group, n=1 (1.0%) in the liquid bubble group; P=0.71) and 26 eyes required a re-bubbling procedure for incomplete graft adherence (n=16 (12%) in the no-touch group, n=10 (10%) in the liquid bubble group; P=0.37).

Conclusion

Clinical outcomes after DMEK are comparable for grafts prepared by either the manual no-touch peeling technique or the modified liquid bubble technique. While both techniques are safe and useful techniques to prepare DMEK grafts, the modified liquid bubble technique offers advantages for corneas with scars.

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