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Bubble technique for D escemet membrane endothelial keratoplasty tissue preparation in an eye bank: air or liquid?
Author(s) -
Ruzza Alessandro,
Parekh Mohit,
Salvalaio Gianni,
Ferrari Stefano,
Camposampiero Davide,
Amoureux MarieClaude,
Busin Massimo,
Ponzin Diego
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12520
Subject(s) - bubble , air bubble , membrane , endothelial stem cell , materials science , eye bank , descemet membrane , liquid paraffin , chemistry , ophthalmology , cornea , medicine , composite material , physics , biochemistry , in vitro , mechanics
Purpose To compare the big‐bubble method using air and liquid as medium of separation for Descemet membrane endothelial keratoplasty ( DMEK ) lenticule preparation in an eye bank. Methods Donor corneas ( n = 20) were immersed in liquid [tissue culture medium ( TCM )]. Air and liquid was injected using a 25‐gauge needle in the posterior stroma or as near to the stroma‐Descemet membrane ( DM ) phase as possible to create a complete bubble of larger diameter. The endothelial cell density and mortality were checked pre‐ and postbubble after deflating the tissue. Four pairs of tissues were used to analyse the intracellular tight junctions and three pairs for histological examination and DNA integrity studies, respectively. Results The yield obtained using air was 80%, whereas that with liquid was 100%. Single injection was required in six cases; twice in two cases; three and four times in one case each with air bubble, whereas seven cases required single injection; twice in two cases; and thrice in just one case with liquid bubble. The average diameter of the final lenticule was 9.12 (± 1.71) mm for air bubble and 9.78 (± 1.75) mm for liquid bubble with p = 0.4362 (no statistical significance). Endothelial cell mortality postbubble preparation was 8.9 (± 12.38) % for air and 6.25 (± 9.57) % for liquid (p = 0.6268). Conclusions DM and endothelium could be separated exclusively using air or liquid bubble. However, liquid bubble seems to have certain advantages over air such as the generation of yield, larger diameter and higher maintenance of endothelial cell density and integrity.