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Descemet Membrane Endothelial Keratoplasty Using Tissues From Donors With a History of Radial Keratotomy

Boulter, Tyler, MD*; Rayl, Sarah, BS; McEntire, M. Wade, MPH; Mifflin, Mark, MD†,‡

doi: 10.1097/ICO.0000000000001920
Case Report
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SDC

Purpose: We report 2 successful cases of Descemet Membrane Endothelial Keratoplasty using transplanted tissues from donors with a history of radial keratotomy (RK).

Methods: Four corneas were obtained from 2 donors with a history of RK. After one successful laboratory practice preparation of Descemet Membrane Endothelial Keratoplasty (DMEK) for each patient, 2 additional donor tissues were prepared for DMEK using the established eye bank protocols.

Results: Recipient 1 was a 69-year-old female patient who underwent DMEK 6 hours after eye bank preparation of the graft. The postoperative course was uneventful with a clear, attached graft noted at all postoperative visits. The endothelial cell count of the recipient at 7 months was 1953 cells/mm2, and the best-corrected distance visual acuity at 1 year was 20/25 + 2. Recipient 2 was a 79-year-old male patient whose DMEK surgery was performed 18 hours after eye bank preparation of the graft. The postoperative course was notable for a re-bubble with air at postoperative day 4 for a peripheral 30% detachment of the donor tissue. No adverse events were noted, with a clear, attached graft at all postoperative visits. A recipient cell count at 6 months showed 2024 cells/mm2, and the best-corrected distance visual acuity at 1 year was 20/20.

Conclusions: Two patients received successful DMEK grafts using tissues from donors with a history of RK. Careful eye bank screening and processing of RK donor tissues has thus far yielded similar outcomes in our recipient patients to what would be expected using tissues from donors without a history of RK.

*Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI;

Utah Lions Eye Bank, Murray, UT; and

Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT.

Correspondence: Mark Mifflin, MD, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132 (e-mail: mark.mifflin@hsc.utah.edu).

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

Received September 08, 2018

Received in revised form January 04, 2019

Accepted January 25, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.