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Postmortem Ultrastructural Analysis of a Cornea Transplanted With Descemet Membrane Endothelial Keratoplasty

Livny, Eitan MD; Parker, Jack S. MD; van der Kaaij, Mariëlle BASc; Haasdijk, Elize D. Ing; van der Wees, Jacqueline PhD; Bruinsma, Marieke PhD; Melles, Gerrit R.J. MD, PhD

doi: 10.1097/ICO.0000000000000156
Clinical Science

Purpose: The aim of this study was to describe the ultrastructure of the host–donor interface in the eye of a recently deceased patient, who had undergone Descemet membrane endothelial keratoplasty.

Methods: The eye was enucleated postmortem, and after standard decontamination, the corneoscleral button was excised, cut into 4 quadrants, and processed for light and transmission electron microscopy evaluation.

Results: Transmission electron microscopy revealed close attachment of the donor's Descemet membrane to the host's stroma and projection of stromal collagen fibers into the interfacial matrix, resembling a normal “virgin” corneal architecture.

Conclusions: Ultrastructurally, an attached Descemet membrane endothelial keratoplasty graft closely resembles that of an unoperated, healthy eye with no appreciable adventitious or missing structures.

*Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands;

Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands;

Amnitrans Eye Bank Rotterdam, Rotterdam, the Netherlands; and

§Department of Neuroscience, Erasmus Medical Center Rotterdam, the Netherlands.

Reprints: Gerrit R.J. Melles, MD, PhD, Netherlands Institute for Innovative Ocular Surgery, Laan op Zuid 88, 3071 AA, Rotterdam, the Netherlands (e-mail:

G. R. J. Melles is a consultant for DORC International/Dutch Ophthalmic, USA. The remaining authors have no funding or conflicts of interest to disclose.

Received January 23, 2014

Accepted April 13, 2014

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.