The feasibility and efficacy of preparing porcine Descemet's membrane endothelial keratoplasty (DMEK) grafts by two techniques: An ex-vivo investigation for future xeno-DMEK
The feasibility and efficacy of preparing porcine Descemet's membrane endothelial keratoplasty (DMEK) grafts by two techniques: An ex-vivo investigation for future xeno-DMEK
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DOI：
10.1111/xen.12407
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发表时间：
2018-09-01
影响因子：
3.9
通讯作者：
Pan, Zhiqiang
中科院分区：
文献类型：
--
作者：
Liu, Yang;Zhang, Jing;Pan, Zhiqiang
背景后弹力层内皮角膜移植术（DMEK）由于其超薄移植物、极低的排斥反应发生、免缝合移植物固定和最少的免疫抑制方案使用，可能是未来异种角膜移植的一种有前途的技术。本研究旨在探讨两种技术制备猪DMEK移植物的可行性和有效性，并研究移植物的超微结构。方法改进机械剥离技术和液泡技术两种主流技术制备猪DMEK移植物。总共对从 WZS 猪（10-12 月龄）采集的 40 个角膜进行了这些技术（每种技术 20 个角膜）。记录并比较两种技术制备前后的成功率、耗时和内皮细胞密度（ECD）。并用透射电镜观察了猪DEMK移植物的超微结构。此外，还牺牲了9头不同年龄的WZS猪，探讨后弹力层厚度与猪年龄的相关性。结果经过修改多项技术细节，采用机械剥离技术或液体气泡技术成功制备了猪DMEK移植物，并探索了区分移植物两侧的标记技术。总共有 13 例（65%）通过机械剥离技术成功制备了 DMEK 移植物，而 14 例（70%）通过液泡技术成功制备。两种技术之间的成功率没有显着差异 (P=.847)。然而，与液泡技术相比，机械剥离技术非常耗时（P
BackgroundDescemet's membrane endothelial keratoplasty (DMEK) might be a promising technique for future xeno-corneal transplantation due to its ultrathin graft, extremely low rejection occurrence, suture-free graft fixation, and minimal immunosuppressive regime usage. The aim of this study is to explore the feasibility and efficacy of preparing porcine DMEK grafts by 2 techniques and investigate the graft ultrastructure.MethodsTwo mainstream techniques, mechanical stripping technique and liquid bubble technique, were modified to prepare the porcine DMEK grafts. In all, 40 corneas harvested from WZS-pigs (aged 10-12months) were subjected to the techniques (20 corneas for each technique). The success rate, time consumption, and endothelial cell density (ECD) before and after preparation were recorded and compared between the 2 techniques. And the ultrastructure of the porcine DEMK graft was investigated by transmission electron microscope. In addition, 9 WZS-pigs with different ages were sacrificed to explore the correlation between the thickness of Descemet's membrane and porcine age.ResultsAfter modifying several technical details, the porcine DMEK grafts were successfully prepared by either mechanical stripping technique or liquid bubble technique, and the mark technique to distinguish the 2 sides of the graft was also explored. In all, 13 DMEK grafts (65%) were prepared successfully by the mechanical stripping technique, whereas 14 successful cases (70%) were prepared by the liquid bubble technique. The success rates between the 2 techniques showed no significant difference (P=.847). However, the mechanical stripping technique was significantly time-consuming when compared with the liquid bubble technique (P