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Simple novel surgical device to facilitate preparation of endothelial grafts for DMEK
Session Title: Cornea surgical I
Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30
Paper Time: 09:06
Venue: Forum (Ground Floor)
First Author: : M.Muraine FRANCE
Co Author(s): : d. TOUBEAU J. GUEUDRY S. LEFEVRE
Descemets membrane and endothelial keratoplasty (DMEK) is the only technique to achieve a posterior corneal transplant without any interface. It is however difficult to achieve, mainly during the preparation of the graft. We propose a simple novel surgical device to facilitate this preparation.
We used 12 corneas for research in this study. The device is in the form of a circular blade with a diameter of 8.5 mm. The blade is broken in two opposite points on 4 mm. The blade is applied to the cornea in order to cut Descemet"s membrane and deep stroma. Preparation of the endothelial graft is performed on an artificial anterior chamber using a simple technique with a 27 gauge cannula to detach Descemets membrane.
The dissection is performed under the microscope by a corneal bank technician in 4 cases, by a resident in 4 cases and by a cataract surgeon in 4 cases. The three operators followed a specific course on the same day of dissection but had never tried to dissect a DMEK graft before.
Endothelial cell density (ECD) was measured before dissection and 3 days after storage in organ culture. Histological analysis were performed.
Descemet graft could be easily dissected in 11 cases and resident failed dissection in one case.
ECD was 2643±280 cells/mm² before dissection and 2520+/-320 cells/mm², after 3 days in organ culture (p<0.01). Histological sections confirm that the cleavage was between DM and posterior stroma.
We report here a reliable and efficient technique for the preparation of pure descemetic grafts.
... gains financially from product or procedure presented