Endothelial Cell Viability of Pre-Processed DSEK and DMEK Corneal Donor Transplants

Authors

Saujyana Vadoothker, MD, Nishant Soni, MD, Sheindel Ifrah, BA, Sudeep Pramanik, MD, MBA, Angelique Pillar, MD

Keywords

Descemet’s Membrane Endothelial Keratoplasty, Descemet’s Stripping Automated Endothelial Keratoplasty, corneal endothelial cell

Abstract

Purpose: To determine the viability of endothelial cells using vital dye staining in processed Descemet’s stripping automated endothelial keratoplasty (DSEK) and Descemet’s Membrane Endothelial Keratoplasty (DMEK) tissue stored for extended periods of time.

Methods: Trypan blue and alizarin red staining was performed on DSEK donors processed at 1, 2-4, 5-7, and >7 days prior to evaluation and DMEK donors processed at 1, 2-4, and 5-7 days prior to evaluation. Penetrating keratoplasty (PK) donors were used as controls. Grafts were photographed and analyzed to quantify endothelial cell damage by grading software, Adobe Photoshop 7.0.

Results: 46 corneas (17 PK, 18 DSEK, and 11 DMEK donors) were evaluated. DSEK tissue prepared one day prior to surgery had 6.4% endothelial cell damage compared to 8.2% in DSEK donors processed by 2-4 days, 5.2% processed by 5-7 days, 4.5% processed >7 days (single factor analysis of variance, P = 0.6). DMEK tissue prepared one day prior to surgery had 2.0% damage compared to 3.8% in donors processed by 2-4 days, and
5.3% processed by 5-7 days (single factor analysis of variance, P = 0.4). There was no significant effect of preservation time (<7 vs 7-14 days) on endothelial cell viability between control PK and DSEK/DMEK donors (PK 3.1% vs 5.5%, P = 0.7; DSEK 7.2% vs 5.1%, P = 0.3; DMEK 4.4% vs 1.6%, P =0.1).

Conclusion: Extended storage of processed DSEK and DMEK tissue has no significant effect on endothelial cell viability up to seven days after tissue preparation, supporting the use of corneas prepared greater than one day prior to surgery.