Display options
Cite
Romano V, Kazaili A, Pagano L, et al. Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate. Br J Ophthalmol. 2020;doi: 10.1136/bjophthalmol-2020-317608.
Romano, V., Kazaili, A., Pagano, L., Gadhvi, K. A., Titley, M., Steger, B., Fernández-Vega-Cueto, L., Meana, A., Merayo-Lloves, J., Diego, P., Akhtar, R., Levis, H. J., Ferrari, S., Kaye, S. B., & Parekh, M. (2020). Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate. The British journal of ophthalmology, . https://doi.org/10.1136/bjophthalmol-2020-317608
Romano, Vito, et al. "Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate." The British journal of ophthalmology vol. (2020). doi: https://doi.org/10.1136/bjophthalmol-2020-317608
Romano V, Kazaili A, Pagano L, Gadhvi KA, Titley M, Steger B, Fernández-Vega-Cueto L, Meana A, Merayo-Lloves J, Diego P, Akhtar R, Levis HJ, Ferrari S, Kaye SB, Parekh M. Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate. Br J Ophthalmol. 2020 Oct 30; doi: 10.1136/bjophthalmol-2020-317608. Epub 2020 Oct 30. PMID: 33127828.
Copy Download .nbib Format: NLM
Share it on

Br J Ophthalmol. 2020 Oct 30; doi: 10.1136/bjophthalmol-2020-317608. Epub 2020 Oct 30.

Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate.

The British journal of ophthalmology

Vito Romano, Ahmed Kazaili, Luca Pagano, Kunal Ajit Gadhvi, Mitchell Titley, Bernhard Steger, Luis Fernández-Vega-Cueto, Alvaro Meana, Jesus Merayo-Lloves, Ponzin Diego, Riaz Akhtar, Hannah J Levis, Stefano Ferrari, Stephen B Kaye, Mohit Parekh

Affiliations

  1. Instituto Universitario, Universidad de Oviedo and Fundacion de Investigacion Oftalmologica, Oviedo, Spain [email protected].
  2. Ophthalmology, Royal Liverpool University Hospital, Liverpool, UK.
  3. Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  4. Department of Biomedical Engineering, College of Engineering, University of Babylon, Hillah, Iraq.
  5. Babylon Health Directorate, Ministry of Health, Babylon, Iraq.
  6. Department of Mechanical, Materials and Aerospace Engineering, University of Liverpool School of Engineering, Liverpool, UK.
  7. Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria.
  8. Instituto Universitario, Universidad de Oviedo and Fundacion de Investigacion Oftalmologica, Oviedo, Spain.
  9. International Centre for Ocular Physiopathology, Fondazione Banca Degli Occhi del Veneto, Venezia Zelarino, Italy.
  10. UCL, London, UK.

PMID: 33127828 DOI: 10.1136/bjophthalmol-2020-317608

Abstract

AIM: To investigate the difference in adhesion and rebubbling rate between eye bank and surgeon prepared Descemet membrane endothelial keratoplasty (DMEK) tissues.

METHODS: Laboratory and clinical retrospective comparative interventional case series. Research corneal tissues were obtained for laboratory investigation. The clinical study involved patients with endothelial dysfunction who underwent DMEK surgery and tamponade with air. Tissues were stripped using a standard DMEK stripping technique (SCUBA) and shipped as prestripped or loaded in a 2.2 intra-ocular lens cartridge with endothelium facing inwards (preloaded) before transporting from the eye bank to the surgeon. For surgeon prepared tissues, all the grafts were stripped in the theatre and transplanted or stripped in the laboratory and tested immediately. Adhesion force and elastic modulus were measured in the centre and mid-periphery in a laboratory ex vivo investigation using atomic force microscopy, while rebubbling rates were recorded in the clinical study.

RESULTS: There was no difference in endothelial cell viability between surgeon or eye bank prepared tissue. Surgeon-stripped DMEK grafts in the laboratory investigation showed significantly higher elastic modulus and adhesion force compared to prestripped and preloaded tissues (p<0.0001). In the clinical data, rebubbling rates of 48%, 40% and 15% were observed in preloaded, prestripped and surgeon-stripped DMEK grafts, respectively. Rebubbling rates were significantly associated with combined cataract surgery (p=0.009) and with time from harvesting the graft to the surgery (p=0.02).

CONCLUSIONS: Decreased adhesion forces and elastic modulus in eye bank prepared tissues may contribute to increased rebubbling rates.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Keywords: Cornea; Treatment Surgery

Conflict of interest statement

Competing interests: None declared.

Publication Types