Automated Donor Tissue Preparation for Descemet Membrane Automated Endothelial Keratoplasty (DMAEK): An Experimental Study

Background and Objective:Graft harvesting for Descemet membrane endothelial keratoplasty (DMEK) occurs manually and demonstrates surgical difficulties. In the current study, a mechanical automated technique for preparing a donor Descemet membrane (DM) carrying autologous endothelium for DMEK was evaluated.Materials and Methods:Ten rabbit corneas were placed on an artificial anterior chamber and mechanical separation of the DM was conducted using an Epi-keratome (Senturium; Norwood Abbey EyeCare, Victoria, Australia). All DM specimens were properly fixated and optical microscopy was performed.Results:DM separation was achieved in a controlled fashion in 7 of 10 eyes. As demonstrated by optical microscopy of the specimens, no corneal stroma was attached on the DM, whereas the endothelial layer was preserved in several areas.Conclusion:Automated separation of the DM can be achieved using an Epi-keratome. Additional studies and improvements of the current technique are needed to draw final conclusions.