A new technique for preparing corneal tissue for transplantation has been shown to be safe and effective, while providing a faster, smoother process than the traditional technique.
In recent years, Descemet’s membrane endothelial keratoplasty (DMEK) – a partial-thickness corneal transplantation – has emerged as an effective treatment for patients with Fuchs’ dystrophy.
The inherited disease affects the cornea, accelerating cell death in the endothelium, the innermost layer of the cornea, and causing vision impairment and discomfort.
Early symptoms include blurry vision or glare that is often worse in the mornings and improves as the day goes on. Typically, the age of onset is between 40 and 50 years, with women three times more likely than men to develop the disease.1
ENDOGLIDE V JONES TOOL
Dr Karen Christopher from the Department of Ophthalmology at University of Colorado School of Medicine led a study, published in Cornea,2 comparing different tissue preparation techniques for DMEK.
One technique used a relatively new tool called the DMEK EndoGlide and one used a Jones tube, a tool modified from a glass tube that has been used in tear drainage surgery.
The EndoGlide technique preserves the tissue in a tiny capsule, ready for forceps to pull the tissue into the eye during surgery.
The study found it performed comparably to the modified Jones tube technique, which has been used for DMEK surgery for many years. Dr Christopher said this was the first direct comparison of the Jones tube with the EndoGlide technique, and the latter provided more control for the surgeon during the transplantation, leading to faster and more regulated tissue implantation – and likely better long-term outcomes.
The study also compared both techniques with and without viscoelastic material to protect the endothelium, finding the use of the “viscoelastic material to protect the endothelium actually resulted in increased cell loss in the area of its application, resulting in overall higher rates of cell loss across the DMEK tissue”.2
Dr Christopher said DMEK was a “great procedure because it has wonderful visual outcomes and a much lower risk of transplant problems down the road compared with older transplant techniques”.
“It can really restore vision-related quality of life for patients who suffer from symptoms of Fuchs’ dystrophy, and our research shows we can do this more successfully now than ever before.”3
References
- news.cuanschutz.edu/ophthalmology/the-future-of-fuchsdystrophy.
- Christopher, K. L., Terrin, S., Lohmeier, J., et al., Comparison of the Modified Jones Tube Technique and the DMEK EndoGlide Technique With and Without Viscoelastic Material for DMEK Tissue Preparation. Cornea 42(2):p 247-251, February 2023. | DOI: 10.1097/ICO.0000000000003178.
- news.cuanschutz.edu/ophthalmology/improved-treatmenttechnique- for-fuchs-dystrophy-shows-promise
