Early Clinical Outcomes Using Eye Bank–Prepared Pre-Peeled Dmek Tissue: First Uk Experience

To evaluate early clinical outcomes following the first use of pre-peeled Descemet membrane endothelial keratoplasty (DMEK) tissue prepared by NHS Blood and Transplant.

Norfolk and Norwich Univeristy Hospital NHS Foundation Trust, United Kingdom.

Prospective consecutive case series of five eyes undergoing DMEK using eye bank–prepared pre-peeled tissue. Procedures included standalone DMEK and combined phacoemulsification with intraocular lens implantation. Postoperative assessment was performed at day 1, week 1, and month 1. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber inflammation, and central corneal thickness (CCT) measured by anterior segment OCT.

All eyes demonstrated rapid corneal deturgescence. Day-1 CCT ranged from 512–904 µm, reducing by week 1 to 505–589 µm in four eyes and 678 µm in one eye. Visual acuity improved in all cases; by one month, three eyes achieved BCVA ≥6/9 and all were ≥6/18 with pinhole. One combined phaco-DMEK eye had transient IOP elevation (26 mmHg) resolving with topical timolol; two further eyes required topical therapy for raised IOP during follow-up. Mild anterior chamber inflammation in one eye resolved with short-term steroid intensification. No primary graft failure, graft detachment requiring rebubbling, or intraoperative complications occurred.

Eye bank–prepared pre-peeled DMEK tissue demonstrated favourable early anatomical and visual outcomes with an acceptable safety profile. This approach may reduce intraoperative tissue handling and facilitate broader adoption of DMEK. Larger studies with longer follow-up are required to evaluate endothelial cell survival and cost-effectiveness within routine practice.