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.