Feasibility of Descemet Membrane Endothelial Keratoplasty With Preloaded and Trifolded Graft After 96-Hour Storage and Shipping
Year: 2025
Type: article
Study design: Case Report
Abstract: Purpose: Descemet membrane endothelial keratoplasty (DMEK) donor grafts can be safely trifolded, preloaded, and shipped for up to 96 hours without significant endothelial cell loss; however, clinical outcomes of such storage times have yet to be reported in human patients. Here, we report a case of a trifolded, preloaded DMEK graft stored for 96 hours and transplanted in a 68-year-old woman with Fuchs endothelial dystrophy. Methods: DMEK graft was preloaded and trifolded with postprocessing endothelial cell density of 2558 cells/mm 2 . Intraoperatively, it was pulled into the anterior chamber with 27-G irrigating forceps, opened as a sheet, and was positioned without complication using SF 6 gas with 80% fill. The graft was attached at all postoperative day visits including day 1, 5, and week 6. Result: At the 1 week postoperative visit, the DMEK graft was fully attached with clear cornea, and the patient's vision had improved from counting fingers to 20/60. Specular microscopy resulted in endothelial cell density of 1930 cells/mm 2 (endothelial cell loss of 22.8%). At the 6 week postoperative visit, central pachymetry improved from 530 microns preoperatively to 493. Conclusions: We demonstrate feasibility of DMEK with a preloaded and trifolded graft stored for 96 hours, with resolution of corneal edema. These results underscore the viability of international shipment and optimized resource distribution of donor tissue where there is a high global need for DMEK grafts.
Institutions: Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funder: National Eye Institute
Award: G5198366491
OpenAlex ID: W4409539843