Donor preparation using pneumatic dissection in endothelial keratoplasty: DMEK or DSEK?

Purpose: To determine if residual stroma remains on the Descemet membrane when pneumatic dissection is used to prepare donor tissue for endothelial keratoplasty.

Methods: Pneumatic dissection using a posterior peripheral needle insertion was carried out on 5 eye bank corneas. Samples were then sent for histological analysis.

Results: A thin layer of stroma remained on the Descemet membrane in all the samples. The average central stromal thickness was 12.4 μm (range 6.5-20.0 μm).

Conclusions: Endothelial keratoplasty using pneumatic dissection to prepare donor tissue should be considered a form of Descemet stripping endothelial keratoplasty and not Descemet membrane endothelial keratoplasty. If future studies show excellent visual results using pneumatic dissection for endothelial keratoplasty, then removal of all donor stroma may be unnecessary.