The following summary from the ESCRS Publications Committee highlights why they consider this a 'Landmark' article.
Using pre-cut pre-loaded endothelial tissue for endothelial keratoplasty approach is feasible and provide good tissue survival for at least four days, according to recent study. The authors of the study prepared 20 pre-cut and pre-loaded human donor corneas unsuitable for transplantation with endothelial cell density in a range of 1600-2700 cells/mm(2). After punching out an 8.5 mm diameter corneal button and stripping the endothelial, they manually tri-folded the tissue with the endothelial side inward. They then gently inserted the excised membranes into a 2.2 intraocular lens (IOL) cartridge which they filled with transport media (TM) and sealed at both ends. Average stripping and loading time was 20 and 4.5 minutes, respectively. After four days of being preserved at room temperature, the membranes had a mean endothelial cell loss of 4.35 per cent with 3.55 per cent 89 per cent mortality and 7.80 % (± 14.12%) uncovered areas. Active metabolism was shown by the consumption of an average consumption of 0.55 (± 0.26) mg/mL of during storage. The authors note that preloading DMEK grafts can simplify the surgery with better reproducibility, reduced surgical time, and reduced tissue wastage, cost, and logistical requirements.