Clinical outcome analysis of two approaches to trypan blue dyeing for DMEK

To evaluate the clinical implications of the different trypan blue dyeing techniques used during liquid bubble (LBT) and manual peel (MPT) DMEK lenticule preparation techniques. This study retrospectively compared the degree to which endothelial cells are preserved using selective Descemet Membrane...

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Bibliographic Details
Published in:Scientific reports 2024-07, Vol.14 (1), p.16663-5, Article 16663
Main Authors: Donner, Ruth, Schmidinger, Gerald
Format: Article
Language:English
Subjects:
692/698/690
692/700/565/545/576
Acuity
Aged
Cell Count
Cell density
Coloring Agents
Cornea
Corneal transplantation
Descemet Membrane - surgery
Descemet Stripping Endothelial Keratoplasty - methods
DMEK
Dyes
Endothelial cells
Endothelium
Endothelium, Corneal - cytology
Eye Banking
Eye surgery
Female
Humanities and Social Sciences
Humans
Keratoplasty
Male
Middle Aged
multidisciplinary
Postoperative period
Retrospective Studies
Science
Science (multidisciplinary)
Staining and Labeling - methods
Surgeons
Treatment Outcome
Trypan Blue
Visual Acuity
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Summary:To evaluate the clinical implications of the different trypan blue dyeing techniques used during liquid bubble (LBT) and manual peel (MPT) DMEK lenticule preparation techniques. This study retrospectively compared the degree to which endothelial cells are preserved using selective Descemet Membrane (DM) staining (LBT) versus bath-staining (MPT) when performed by a single surgeon, sourced from a single eye bank. Endothelial cell density measured after the 3-month follow-up was 1805 and 1916 cells/mm 2 respectively, differing significantly (p = 0.012). A double-scroll graft formation was found and maintained until implantation in 94% of preparations with bath staining and 50% of preparations using selective DM staining. Preoperative visual acuity was comparable between preparation techniques at 0.4 logMAR as well as postoperatively, at an average of 0.1 logMAR. Reducing chemical stress on the endothelium by avoiding any contact with trypan blue allows for a significantly higher degree of cell preservation. However, achieving the often-desired double-scroll graft formation was possible less frequently. It remains unclear which factors define the differences graft scrolling behavior observed between LBT and MPT.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-024-67695-2