Validation of a novel device to easy the preparation of endothelial graft for DMEK

Purpose The DMEK is the only technique for endothelial graft without interface. It is however difficult to perform, especially the preparation of the graft. We present in this study a new simple device facilitating the preparation of grafts for DMEK. Methods The device, named “Muraine Punch” is a circular trephine with a blade which was open in two places and a guard to 300 micronmeters deep. The blade was pressed against the endothelial surface so as to sever Descemet's membrane and cut part of stroma. The preparation of descemetic graft was then continued on an artificial anterior chamber using a 27 gauge cannula , reversed upwardly corneal endothelium. Three methods of assessing injury of endothelial cells (ECs) were then performed: 1 / conventional measurement of the endothelial cell density (ECD). 2 / laboratory measurement of the viable ECD by image analysis after staining of ECs by alizarin red, followed an counterstaining using Dioc 6 (cytoplasm) and Hoechst (nucleus). 3/ post operatory ECD of 47 patients. Results Histological analysis confirmed this “Muraine technique” offered a pure Descemet membrane grafts for DMEK. The ECD analysis showed consistent with that of the grafts for transfixant keratoplasty. Conclusion The new technique with “Muraine Punch” facilitates the preparation of grafts for DMEK and causes only a minimal cell loss. Commercial interest