Precut DMEK Using Dextran-Containing Storage Medium Is Equivalent to Conventional DMEK: A Prospective Pilot Study.

PURPOSE: To compare the clinical outcome after Descemet membrane endothelial keratoplasty (DMEK) either as precut or conventional Descemet membrane graft preparation under standard European eye bank organ culture conditions.

METHODS: This was a prospective pilot study of patients receiving either precut or conventional DMEK. Graft preparation was performed using the liquid bubble technique. Precut grafts (n = 22) were prepared 1 day before surgery in the eye bank and stored in dextran-containing organ culture medium within a transport viewing chamber. Conventional grafts (n = 29) were prepared directly before surgery. End point criteria included the endothelial cell count (ECC), central corneal thickness, graft rejection rate, rebubbling rate, and best-corrected visual acuity after 1, 3, and 6 months.

RESULTS: A post hoc matched analysis revealed no statistically significant differences between the 2 groups. The ECC in the precut and conventional groups was comparable with an EC loss of 34% and 35%, respectively, after 6 months. The early graft failure rate, best-corrected visual acuity, and central corneal thickness were comparable between the 2 groups.

CONCLUSIONS: This pilot study shows a comparable clinical outcome after DMEK surgery for precut Descemet membrane grafts versus conventionally prepared grafts, using the liquid bubble preparation technique and storage conditions with dextran-containing medium.