Walter Stark

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A surgical technique for donor tissue harvesting for descemet membrane endothelial keratoplasty.

Shameema Sikder; Donald Ward; Albert S Jun (Profiled Author: Albert Jun)

Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Cornea 2011;30(1):91-4.

PURPOSE: To create a reproducible and effective technique in donor tissue harvesting for Descemet membrane (DM) endothelial keratoplasty. METHODS: A new method has been developed for the harvest of donor DM and endothelium. This method involves placement of a human corneoscleral rim in an artificial anterior chamber with removal of the anterior stroma with a Moria One microkeratome (Moria USA, Doylestown, PA). The residual stromal bed over the central cornea is removed by blunt dissection using a Barraquer sweep. A thin rim of posterior residual stroma permits easy donor button trephination and tissue manipulation. The risk of tearing through DM is minimal and may not preclude use in transplantation. This method allows relatively easy assessment of endothelial integrity before trephination. RESULTS: Optical coherence tomography evaluation revealed minimal stroma overlying DM and endothelium. Endothelial cell integrity of the harvested DM by this new harvest method was assessed using specular microscopy and demonstrated minimal loss after DM harvest. CONCLUSIONS: We presented a manual tissue harvest method for DM endothelial keratoplasty.

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