Technique for preparation of the corneal endothelium-Descemet membrane complex for transplantation

Zejin Zhu, Lawrence Rife, Samuel Yiu, Melvin D. Trousdale, Daniel Wasilewski, Alexandre Siqueira, Ronald E. Smith

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


PURPOSE: Replacing diseased corneal endothelium with a preparation of Descemet membrane carrying functional endothelium and no stroma may be a feasible method for treating corneal endothelial decompensation. To obtain a viable donor of a Descemet membrane endothelium disc, we modified the Descemet membrane stripping technique and monitored the percentage of endothelial damage to the donor tissue preparation. METHODS: Forty-eight human corneas were used. Cornea buttons were mounted on an artificial anterior chamber, endothelial side up. Endothelia were stained with alizarin red, examined under the microscope, and photographed at 5 different sites (microscope, x100; digital magnification, x2.83). A 6 x 7-mm rectangular piece of endothelium-Descemet membrane complex was obtained using a Grieshaber microsurgical knife and Kelman-McPherson forceps. Digital photographs of endothelia were analyzed with a computer, and the percentage of endothelial damage was calculated. Specimens were processed for hematoxylin-eosin staining. RESULTS: Forty of 48 endothelium-Descemet membrane preparations (83.3%) were complete peels with minimal endothelial damage. Endothelial damage before and after the surgery was 1.57 ± 2.11% and 2.61 ± 1.77%, respectively. Eight preparations (16.7%) failed because of tearing. Multiple hematoxylin-eosin-stained sections showed the presence of endothelium with intact Descemet membrane and no stromal tissue. CONCLUSION: We modified the technique of Melles and obtained a sheet of Descemet membrane and endothelium with minimal endothelial damage and with no remaining stroma observed. This simple technique can be used to obtain the endothelium-Descemet membrane complex in minutes. It may be useful for corneal endothelium transplantation.

Original languageEnglish (US)
Pages (from-to)705-708
Number of pages4
Issue number6
StatePublished - Jul 2006
Externally publishedYes


  • Artificial anterior chamber
  • Cornea endothelium-Descemet membrane preparation
  • Corneoscleral button
  • Endothelial transplantation

ASJC Scopus subject areas

  • Ophthalmology


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