Journal
CORNEA
Volume 34, Issue 9, Pages 1175-1178Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICO.0000000000000522
Keywords
DMEK; endothelial keratoplasty; donor tissue preparation; S-stamp; upside-down graft
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Purpose:To report endothelial cell loss (ECL) caused by a novel S-stamp preparation technique for Descemet membrane endothelial keratoplasty (DMEK).Methods:Six cadaveric human corneas were prepared for DMEK transplantation using a single standardized technique, including the application of a dry ink gentian violet S-stamp to the stromal side of Descemet membrane. Endothelial cell death was evaluated and quantified using computerized analysis of vital dye staining.Results:ECL caused by the S-stamp was 0.6% (range 0.1%-1.0%), which comprised less than one-tenth of the total ECL caused by our preparation of the DMEK graft from the start to finish, including recovery, prestripping, S-stamping, and trephination (13.7% total ECL, range 9.9%-17.6%).Conclusions:Our novel S-stamp donor tissue preparation technique is intuitive to learn and holds the promise of preventing iatrogenic primary graft failure due to upside-down grafts without causing unacceptable increases in ECL.
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