RT Journal Article
SR Electronic
T1 Viability of preloaded Descemet membrane endothelial keratoplasty grafts with 96-hour shipment
JF BMJ Open Ophthalmology
JO BMJ Open Ophth
FD BMJ Publishing Group Ltd
SP e000679
DO 10.1136/bmjophth-2020-000679
VO 6
IS 1
A1 Conan Chen
A1 Steven Jared Solar
A1 John Lohmeier
A1 Staci Terrin
A1 Satya Baliga
A1 Batya Gold Wiener
A1 Daniel Schouten Lewis
A1 Eric Chiang
A1 Kali Alexandra Barnes
A1 Akash Chaurasia
A1 Allen O Eghrari
YR 2021
UL http://bmjophth.bmj.com/content/6/1/e000679.abstract
AB Objective To assess feasibility and compare the effects of 96-hour shipment of Descemet membrane endothelial keratoplasty (DMEK) grafts as a scroll or a tri-fold on cell viability.Methods and analysis DMEK grafts were prepared at the Rocky Mountain Lions Eye Bank. Twenty pre-stripped DMEK grafts, paired from 10 donors, were either tri-folded in an endothelium-in configuration using microforceps and loaded into a plastic Treyetech cartridge, or suctioned in a scrolled endothelium-out configuration into a modified Jones Tube. Grafts were shipped via FedEx to a secondary location and back for 48 hours each way, resulting in a total shipping time of 96 hours. After shipping, grafts were removed from inserters onto glass slides and unfolded using viscoelastic with endothelium facing upwards. Calcein-AM stained grafts were imaged with a fluorescent microscope and endothelial cell loss (ECL) was measured using trainable segmentation in Fiji by a masked grader.Results A total of 20 grafts were shipped for 96 hours, split between preloaded tri-folded (n=10) and preloaded scrolled (n=10) tissues. No significant difference in ECL was observed across groups after prolonged shipping (14.8% vs 13.7% ECL respectively, p=0.68).Conclusion For preloaded DMEK after 96 hours, both scrolled and tri-folded tissue demonstrated clinically acceptable levels of ECL. The data suggest a wider window of time for endothelial cell viability and is promising for the prospect of international shipment of preloaded grafts.All data relevant to the study are included in the article.