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Evaluation of a New Technique for Preparation of Endothelial Grafts for Descemet Membrane Endothelial Keratoplasty

Brissette, Ashley MD; Conlon, Ronan MD; Teichman, Joshua C MD, MPH, FRCSC; Yeung, Season MBBS, FRANZCO; Ziai, Setareh MD, FRCSC; Baig, Kashif MD, MBA, FRCSC

doi: 10.1097/ICO.0000000000000394
Basic Investigation

Purpose: The purpose of this study was to compare the Muraine technique, a relatively new method for preparing endothelial grafts for Descemet membrane endothelial keratoplasty (DMEK), with the current standard submerged cornea using backgrounds away (SCUBA) peeling technique.

Methods: This study was a prospective ex vivo investigation. In a wet-lab setting, 20 donor corneas were prepared for DMEK using The Muraine technique and 20 donor corneas using the SCUBA technique. In each of the technique groups, 10 corneas were prepared by a corneal surgeon and 10 were prepared by a corneal fellow. Primary outcome measures were the time needed to prepare endothelial grafts and the number of graft tears.

Results: In the SCUBA technique, median time to prepare grafts was shorter for both the surgeon (301 ± 85 seconds) and fellow (523 ± 58 seconds) compared with the Muraine technique (surgeon, 359 ± 83 seconds; fellow, 543 ± 44 seconds). However, these findings were not statistically significant (surgeon, P = 0.33; fellow, P = 0.24; pooled, P = 0.46). There was a statistically significant difference between surgeon time and fellow time for each technique (SCUBA technique, P = 0.0005; Muraine technique, P = 0.002). In the Muraine technique, there were 5 graft tears (surgeon = 2, fellow = 3), and no graft tears in the SCUBA technique, which was statistically significant (P = 0.047).

Conclusions: The present study demonstrates that the SCUBA technique may be a more effective technique to prepare endothelial donor grafts for DMEK.

*Department of Ophthalmology, Queen's University, Kingston, ON, Canada; and

University of Ottawa Eye Institute, Ottawa, ON, Canada.

Reprints: Kashif Baig, MD, MBA, FRCSC, University of Ottawa Eye Institute, 501 Smyth Rd, Suite W6223, Ottawa, ON K1H 8L6, Canada (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received September 12, 2014

Received in revised form January 02, 2015

Accepted January 11, 2015

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