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Evaluation of endothelial/Descemet membrane complex of eye bank donor corneas using enhanced depth imaging optical coherence tomography

Authors Syed ZA, Gameiro GR, Ruggeri M, Elsawy A, Sayed-Ahmed I, Roongpoovapatr V, Abdel-Mottaleb M, Abou Shousha M

Received 27 August 2018

Accepted for publication 16 November 2018

Published 8 May 2019 Volume 2019:13 Pages 789—794


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Zeba A Syed,1 Gustavo Rosa Gameiro,1 Marco Ruggeri,1 Amr Elsawy,1,2 Ibrahim Sayed-Ahmed,1 Vatookarn Roongpoovapatr,1 Mohamed Abdel-Mottaleb,2 Mohamed Abou Shousha1

1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Electrical and Computer Engineering, University of Miami College of Engineering, Coral Gables, FL, USA

Objective: We present a novel method for screening eye bank donor corneas using high definition optical coherence tomography (HD-OCT). This technology allows for the quantification of endothelial/Descemet membrane (En/DM) complex thickness ex vivo.
Design: Prospective interventional study.
Participants: Fifty-two corneal grafts from 27 donors were included in this study. Twenty additional control eyes and 11 eyes with Fuchs’ endothelial corneal dystrophy were also evaluated for comparison.
Methods: A custom built, high speed HD-OCT device (Envisu R2210, Bioptigen, Buffalo Grove, IL, USA) was used to obtain images, and custom-made graph-based segmentation software was used to automatically deconstruct corneal images into micro-layers. HD-OCT imaging was used to scan through the sealed sterile case of donor corneas stored in McCarey-Kaufman medium to image their En/DM complex through the center of the cornea.
Results: This technology allowed for quantification of En/DM complex thickness in all donor corneas through the sealed sterile container used to transport graft tissue. Mean En/DM complex thickness of donor corneas was 17±4 μm. The difference between donor cornea En/DM thickness and that of control subjects (16±2 μm) was not statistically significant (p=0.3), suggesting that the transport container and media do not affect measurements. There was a significant difference between En/DM thickness of Fuchs’ endothelial corneal dystrophy eyes (25±5 μm) and both donor corneas (p<0.0001) and control subjects (p<0.0001).
Conclusions: We have described a new technique to measure En/DM complex thickness in eye bank donor corneas stored in a sealed sterile case. This may represent a novel adjunctive approach to screen corneal grafts for early endothelial disease.

Keywords: corneal transplant, Fuchs’ endothelial corneal dystrophy, corneal graft screening, microscope-integrated OCT

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