Effects of temperature and fluid media on the scroll width size of the Descemet’s membrane endothelial keratoplasty (DMEK) donor graft

Abstract

Aim

Our study was conducted to evaluate whether higher temperature leads to increased – or wider – scroll widths of the Descemet’s membrane endothelial keratoplasty (DMEK) donor graft.

Purpose

To investigate the effects of temperature and fluid media on the DMEK donor graft scroll widths.

Materials and methods

This research work was a laboratory investigation. Baseline cell count was taken via specular microscopy for the donor corneas at room temperature (20°C–25°C). The endothelium sides of the donor corneas were stained with Trypan Blue Solution 0.4% for 30 s, and the Descemet’s membranes were stripped. The DMEK donor grafts were placed into three different fluid media – Optisol^®, Balanced Salt Solution (BSS), and BSS PLUS^® (BSS Plus). The DMEK donor grafts were then transferred into cold temperature (4°C) for 60 min, after which the donor grafts’ scroll widths were examined and measured. The donor grafts were then warmed in the incubator and brought to physiological temperature (35°C–37°C), and their scroll widths were examined and measured again.

Results

In 30 measurements of ten tissues across three temperature and fluid conditions, the average scroll width measured 1.73 mm, ranging from 1.1 to 2.9 mm. In a mixed linear model, the scroll widths increased with temperature (P=0.02). There was no significant difference in scroll widths among the three solutions (P=0.84, mixed linear model).

Conclusion

We observed an increase in DMEK donor graft scroll widths with higher temperatures. The usage of BSS Plus as media solution could also lead to smaller DMEK donor graft scroll widths, compared with BSS, but our study does not establish this.

Keywords:

• DMEK
• graft scroll
• graft conformation
• DMEK scroll
• DMEK graft

Acknowledgments

This study was funded in part by the NIH Core Center Grant P30EY014801. KeraLink International provided donor tissue grafts and use of their facility for this study.

Disclosure

This scientific study was initiated by the principal investigators (Koo and Eghrari). The authors report no conflicts of interest in this work.