ArticleThe British journal of ophthalmology2018
Comparison of preservation and transportation protocols for preloaded Descemet membrane endothelial keratoplasty.
Article in The British journal of ophthalmology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 75 citations in OpenAlex.
- Endothelial keratoplasty outcomes of domestic versus imported donor corneas.Indian journal of ophthalmology · 2026Article
- Validation of a Deep Learning-Assisted Evaluation of Total Corneal Endothelial Cells Viability.Translational vision science & technology · 2025Article
- Optimized laboratory techniques for assessing the quality of pre-stripped DMEK grafts.Scientific reports · 2025Article
- Clinical outcomes in imported endothelium-in preloaded vs. surgeon-loaded DMEKs in Asian eyes.Frontiers in medicine · 2025Article
- Comparison of rebubbling rate between preloaded endothelium-in and preloaded no-touch endothelium-out Descemet membrane endothelial keratoplasty transplantation.BMC ophthalmology · 2024Article
- Predicting Long-Term Endothelial Cell Loss after Preloaded Descemet Membrane Endothelial Keratoplasty in Fuchs' Endothelial Corneal Dystrophy: A Mathematical Model.Journal of clinical medicine · 2024Article
- Measuring the viability of crystalline lens epithelial cells by triple Hoechst-Ethidium-Calcein-AM staining.Molecular vision · 2024Article
- Incidence and management of early postoperative complications in lamellar corneal transplantation.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023Review
- Inhibiting miR-195-5p Induces Proliferation of Human Corneal Endothelial Cells.International journal of molecular sciences · 2023Article
- Intraoperative OCT for Lamellar Corneal Surgery: A User Guide.Journal of clinical medicine · 2023Review
- Effect of Low-Temperature Preservation in Optisol-GS on Preloaded, Endothelium-Out DMEK Grafts.Journal of clinical medicine · 2023Article
- Clinical results after single asymmetrical shark fin for graft orientation in DMEK.International ophthalmology · 2022Article
- Eye bank versus surgeon prepared DMEK tissues: influence on adhesion and re-bubbling rate.The British journal of ophthalmology · 2022Article
- Comparison of clinical outcomes after precut DMEK with or without dextran-containing medium compared to standard DMEK: a prospective pilot study.International ophthalmology · 2022Article
- Cost analysis of eye bank versus surgeon prepared endothelial grafts.BMC health services research · 2021Article
- Ultra-thin DSAEK using an innovative artificial anterior chamber pressuriser: a proof-of-concept study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021Article
- Viability of preloaded Descemet membrane endothelial keratoplasty grafts with 96-hour shipment.BMJ open ophthalmology · 2021Article
- Corneal Donation: Current Guidelines and Future Direction.Clinical ophthalmology (Auckland, N.Z.) · 2021Review
- Clinical outcomes of pre-loaded ultra-thin DSAEK and pre-loaded DMEK.BMJ open ophthalmology · 2020Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsDescemet membrane endothelial keratoplasty (DMEK) preparation is technically demanding and is a limiting factor for uptake of this kind of surgery. Supply methods that simplify the procedure for surgeons are key to increasing uptake. This study compares two different shipping protocols for DMEK.
methodsAn 8.5 mm DMEK graft was punched, marked and loaded for transportation in two different conditions: (A) endothelium trifolded inwards in organ culture conditions (n=7) and (B) endothelium rolled outwards in hypothermic conditions (n=7). Tissues were shipped from Italy to the UK, then analysed for orientation, endothelial cell density, denuded areas, cell mortality, triple viability staining (Hoechst/ethidium homodimer/calcein AM (HEC)), immunolocalisation of ZO-1 and Na/K-ATPase proteins, visualisation of actin filaments using phalloidin and histological analysis using H&E on paraffin-embedded sections.
resultsAll tissues clearly showed the mark used for graft orientation. After shipping in condition A, there was an increase in cell mortality of 8.1% and in denuded areas of 22.4%, whereas for condition B there was an increase in cell mortality of 14.2% and in denuded areas of 34.3% after shipping. HEC staining revealed areas of viable cells and apoptotic cells, with large denuded areas found in the periphery for condition B and within folds for condition A.
conclusionsPrestripped preloaded DMEK grafts retained sufficient viable cells for transplantation, with condition A (endothelium-in) offering the advantage of greater flexibility of use due to a longer shelf-life. HEC analysis provides further detailed information as to the status of DMEK grafts and should be used in future similar studies.
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