与手动解剖相比，DescePrep 显著提高了糖尿病供体角膜的 Descemet 膜内皮角膜移植处理效率和成功率。

DescePrep Significantly Increases Descemet Membrane Endothelial Keratoplasty Processing Efficiency and Success Rate in Diabetic Human Donor Corneas in Comparison With Manual Dissection.

机构信息

Research and Development, Eyedea Medical, Baltimore, MD.

School of Medicine, Johns Hopkins University, Baltimore, MD.

出版信息

Cornea. 2022 Oct 1;41(10):1284-1290. doi: 10.1097/ICO.0000000000003096. Epub 2022 Jul 6.

DOI:10.1097/ICO.0000000000003096

PMID:35867682

Abstract

PURPOSE

The purpose of this study was to compare the safety, efficacy, and efficiency of a Descemet membrane endothelial keratoplasty (DMEK) graft processing device, DescePrep, with a manual dissection technique through the measurement of tissue yield, processing time, and graft viability in nondiabetic and diabetic donor corneas.

METHODS

Nondiabetic (n = 20) and diabetic (n = 20) donor corneas were processed using DescePrep, which standardizes the liquid bubble technique. Nondiabetic (n = 20) and diabetic (n = 24) donor corneas were also processed through manual dissection. Corneas were stained, processed, and then evaluated for processing success rate and time. Randomly selected corneas (n = 5, each) were evaluated for cell viability using live/dead staining.

RESULTS

One hundred percent of nondiabetic and 95% of diabetic corneas were processed successfully with DescePrep in an average of 3.37 minutes. Ninety percent of nondiabetic and 50% of diabetic corneas were processed successfully with manual dissection in an average of 9.87 minutes. DescePrep had a significantly lower processing time ( P < 0.0001) and significantly higher success rate in comparison with manual dissection. DescePrep grafts had an average cell viability of 91.1% ± 3.3% in nondiabetic and 91.5% ± 2.4% in diabetic corneas. Grafts prepared with manual dissection had an average cell viability of 89.5% ± 5.8% in nondiabetic and 88.1% ± 4.3% in diabetic corneas.

CONCLUSIONS

DescePrep provides a more effective and efficient method of cornea preparation in comparison with the current standard, particularly in diabetic corneas, while providing comparable cell viability. Thus, DescePrep offers standardized DMEK processing that produces high-quality grafts at high yields, with the potential to expand access and improve the quality of DMEK graft preparation in a larger pool of donors.

摘要

目的

本研究旨在比较 Descemet 膜内皮角膜移植术（DMEK）移植物处理设备 DescePrep 与手动解剖技术的安全性、有效性和效率，通过测量组织产量、处理时间和非糖尿病及糖尿病供体角膜中的移植物活力来实现。

方法

使用 DescePrep 对非糖尿病（n=20）和糖尿病（n=20）供体角膜进行处理，该设备使液体气泡技术标准化。也通过手动解剖对非糖尿病（n=20）和糖尿病（n=24）供体角膜进行处理。对角膜进行染色、处理，然后评估处理成功率和时间。使用活/死染色随机选择 5 个（每个）角膜评估细胞活力。

结果

在平均 3.37 分钟内，100%的非糖尿病和 95%的糖尿病角膜使用 DescePrep 成功处理。在平均 9.87 分钟内，90%的非糖尿病和 50%的糖尿病角膜使用手动解剖成功处理。与手动解剖相比，DescePrep 的处理时间明显更短（P<0.0001），成功率更高。DescePrep 移植片在非糖尿病角膜中的平均细胞活力为 91.1%±3.3%，在糖尿病角膜中的平均细胞活力为 91.5%±2.4%。使用手动解剖制备的移植物在非糖尿病角膜中的平均细胞活力为 89.5%±5.8%，在糖尿病角膜中的平均细胞活力为 88.1%±4.3%。