Objective To assess feasibility and compare the effects of 96-hour shipment of Descemet membrane endothelial keratoplasty (DMEK) grafts as a scroll or a tri-fold on cell viability. Methods and analysis DMEK grafts were prepared at the Rocky Mountain Lions Eye Bank. Twenty pre-stripped DMEK grafts, paired from 10 donors, were either tri-folded in an endothelium-in configuration using microforceps and loaded into a plastic Treyetech cartridge, or suctioned in a scrolled endothelium-out configuration into a modified Jones Tube. Grafts were shipped via FedEx to a secondary location and back for 48 hours each way, resulting in a total shipping time of 96 hours. After shipping, grafts were removed from inserters onto glass slides and unfolded using viscoelastic with endothelium facing upwards. Calcein-AM stained grafts were imaged with a fluorescent microscope and endothelial cell loss (ECL) was measured using trainable segmentation in Fiji by a masked grader. Results A total of 20 grafts were shipped for 96 hours, split between preloaded tri-folded (n=10) and preloaded scrolled (n=10) tissues. No significant difference in ECL was observed across groups after prolonged shipping (14.8% vs 13.7% ECL respectively, p=0.68). Conclusion For preloaded DMEK after 96 hours, both scrolled and tri-folded tissue demonstrated clinically acceptable levels of ECL. The data suggest a wider window of time for endothelial cell viability and is promising for the prospect of international shipment of preloaded grafts. All data relevant to the study are included in the article.

中文翻译：

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预装后弹力膜内皮角膜移植移植物 96 小时装运的可行性

目的评估可行性并比较 96 小时运送 Descemet 膜内皮角膜移植 (DMEK) 移植物作为卷轴或三折对细胞活力的影响。方法和分析 DMEK 移植物是在落基山狮子眼库制备的。来自 10 个供体的 20 个预先剥离的 DMEK 移植物要么使用微型镊子以内皮结构三折并装入塑料 Treyetech 盒中，要么以卷起的内皮外结构吸入到改进的琼斯管中。移植物通过 FedEx 运送到第二个地点，然后单程返回 48 小时，总运送时间为 96 小时。运输后，将移植物从插入器移到载玻片上，并使用粘弹性展开，内皮朝上。用荧光显微镜对钙黄绿素-AM 染色的移植物进行成像，并在斐济使用蒙面分级机的可训练分割测量内皮细胞损失 (ECL)。结果 在 96 小时内总共运送了 20 个移植物，分为预加载的三折 (n=10) 和预加载的滚动 (n=10) 组织。在延长运输时间后，各组之间的 ECL 没有显着差异（分别为 14.8% 和 13.7% ECL，p=0.68）。结论 对于 96 小时后的预加载 DMEK，滚动和三折组织均显示出临床上可接受的 ECL 水平。这些数据表明内皮细胞存活的时间窗口更宽，并且对国际运输预加载移植物的前景充满希望。所有与研究相关的数据都包含在文章中。