PURPOSE: Descemet 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. In this talk logistics and outcomes of Eye bank prepared DMEK tissue will be presented. METHODS: Laboratory studies of two different shipping protocols for DMEK (endothelium trifolded inwards and endothelium rolled outwards) will be presented. Clinical outcomes and complications of patients underwent to DMEK surgery with Eye bank prepared or surgeon prepared tissue will be presented. A Cost analysis of eye bank versus surgeon prepared endothelial grafts will be also part of the presentation. RESULTS: There was no difference in endothelial cell viability between surgeon or eye bank prepared tissue. Surgeon-stripped DMEK grafts in the laboratory investigation showed significantly higher elastic modulus and adhesion force compared to prestripped and preloaded tissues (p<0.0001). In the clinical data, rebubbling rates of 48%, 40% and 15% were observed in preloaded, prestripped and surgeon-stripped DMEK grafts, respectively. The cost analysis showed that eye bank prepared tissues had higher surgical expenses compared to those prepared by the surgeon, while the post-operative care expenses were similar between the two groups CONCLUSION: The Eye bank prepared tissues are a valid alternative to Surgeon prepared tissue, however need to be highlighted that with current method there is a decreased adhesion forces and elastic modulus in eye bank prepared tissues that may contribute to increased rebubbling rates.
P44-A104 Logistics and results with precut and preloaded graft for DMEK
Romano V.
2023-01-01
Abstract
PURPOSE: Descemet 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. In this talk logistics and outcomes of Eye bank prepared DMEK tissue will be presented. METHODS: Laboratory studies of two different shipping protocols for DMEK (endothelium trifolded inwards and endothelium rolled outwards) will be presented. Clinical outcomes and complications of patients underwent to DMEK surgery with Eye bank prepared or surgeon prepared tissue will be presented. A Cost analysis of eye bank versus surgeon prepared endothelial grafts will be also part of the presentation. RESULTS: There was no difference in endothelial cell viability between surgeon or eye bank prepared tissue. Surgeon-stripped DMEK grafts in the laboratory investigation showed significantly higher elastic modulus and adhesion force compared to prestripped and preloaded tissues (p<0.0001). In the clinical data, rebubbling rates of 48%, 40% and 15% were observed in preloaded, prestripped and surgeon-stripped DMEK grafts, respectively. The cost analysis showed that eye bank prepared tissues had higher surgical expenses compared to those prepared by the surgeon, while the post-operative care expenses were similar between the two groups CONCLUSION: The Eye bank prepared tissues are a valid alternative to Surgeon prepared tissue, however need to be highlighted that with current method there is a decreased adhesion forces and elastic modulus in eye bank prepared tissues that may contribute to increased rebubbling rates.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
