Purpose: 

The purpose of this study was to describe a novel bandage contact lens (BCL) interface technique for marking the Descemet membrane endothelial keratoplasty (DMEK) graft so that a single donor cornea can be used effectively for 2 recipients during acute shortage.

Methods: 

This was a retrospective comparative case series. In group A, 37 eyes underwent DMEK using a graft marked by the ‟BCL interface technique” that was compared with 49 conventional DMEK grafts marked through the stromal window (group B). In group A, a resized BCL with a central 3-mm hole with the concavity up was placed between the stroma and peeled-off DM. This BCL with DM was flipped for S-stamping on the DM side. Final trephination was performed on a second Teflon block. The remaining anterior lamellar tissues of group A were used on the same day for other keratoplasty procedures. Endothelial cell density (ECD) and endothelial cell loss between the 2 groups were compared after 3 and 6 months.

Results: 

The ECD at 3 months in group A (n = 35) versus group B (n = 45) was 2228 ± 270/mm² versus 2302 ± 254/mm² (P = 0.48), and the ECD at 6 months (n = 23 and 22) was 2058 ± 324/mm² versus 2118 ± 260/mm² (P = 0.72). The corresponding endothelial cell loss was 23.3% ± 6.8% versus 20.3% ± 6.1% (P = 0.18) at 3 months and 29.1% ± 8.4% versus 26.7% ± 8.0% (P = 0.34) at 6 months. Among anterior tissues of group A, 17 (45.9%) were used for deep anterior lamellar keratoplasty, 18 (48.6%) were used for larger therapeutic and tectonic grafts, and 2 were used as keratoprosthesis carriers. Donor detachment rate (8.6% vs. 8.9%) was similar in both groups without primary graft failures.

Conclusions: 

The BCL interface technique is a simple and safe technique for stamping DMEK grafts. Anterior corneal tissues can be used for additional keratoplasties during donor shortage.

中文翻译：

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使用绷带隐形眼镜接口技术标记 DMEK 移植物：在供体角膜严重短缺期间将利用率提高一倍

目的： 

本研究的目的是描述一种用于标记后弹力层内皮角膜移植术 (DMEK) 移植物的新型绷带隐形眼镜 (BCL) 接口技术，以便在严重短缺期间可以有效地将单个供体角膜用于 2 个受体。

方法： 

这是一个回顾性比较案例系列。在 A 组中，37 只眼使用“BCL 界面技术”标记的移植物接受 DMEK，与 49 只通过基质窗标记的传统 DMEK 移植物（B 组）进行比较。在 A 组中，在基质和剥离的 DM 之间放置一个调整大小的 BCL，其中央有一个 3 毫米的孔，凹面朝上。这个带有 DM 的 BCL 在 DM 侧被翻转以进行 S 冲压。在第二个聚四氟乙烯块上进行最后的环钻。A组剩余的前板层组织在同一天用于其他角膜移植手术。在 3 个月和 6 个月后比较两组之间的内皮细胞密度 (ECD) 和内皮细胞丢失。

结果： 

A 组 (n = 35) 与 B 组 (n = 45) 3 个月时的 ECD 分别为 2228 ± 270/mm ²和 2302 ± 254/mm ² ( P = 0.48)，6 个月时的 ECD (n = 23 和 22) 为 2058 ± 324/mm ²与 2118 ± 260/mm ² ( P = 0.72)。相应的内皮细胞损失在 3 个月时分别为 23.3% ± 6.8% 和 20.3% ± 6.1% ( P = 0.18)，以及 29.1% ± 8.4% 和 26.7% ± 8.0% ( P= 0.34) 在 6 个月时。在A组的前壁组织中，17个（45.9%）用于深板层角膜移植术，18个（48.6%）用于较大的治疗性和构造移植物，2个用于角膜修复体载体。两组的供体脱离率（8.6% 对 8.9%）相似，没有原发性移植失败。

结论： 

BCL 界面技术是一种简单而安全的冲压 DMEK 移植物的技术。在供体短缺期间，前角膜组织可用于额外的角膜移植术。