New Preparation Techniques

Under the flag of NIIOS, AER has developed new preparation techniques for lamellar corneal transplantation procedures such as DSEK (Descemet stripping endothelial keratoplasty), DMEK (Descemet membrane endothelial keratoplasty) and Bowman layer transplantation. For DMEK graft preparation, we use the “no-touch” technique: the graft tissue does not get into contact with any instruments during preparation. This eliminates the risk of damaging the tissue to be transplanted. We also make use of a modified liquid bubble dissection technique. The end-product is a ready-to-use DMEK scroll at the desired diameter, freely floating in organ culture medium without dextran.

Read more about Amnitrans EyeBank’s tissue cornea products.

Expanding the Tissue Supply

The lamellar techniques developed by Amnitrans EyeBank Rotterdam have expanded the supply of graft tissue available to patients. For example, a cornea that is not suitable for a full-thickness transplant due to scarring on its anterior side no longer has to be discarded, as used to be the case in the past. As long as sufficient numbers of vital endothelial cells are present, the tissue can be used for a posterior lamellar keratoplasty procedure such as DSEK or DMEK.

One donor cornea can sometimes be used for two patients: the anterior part for a DALK (deep anterior lamellar keratoplasty) or a Bowman layer transplantation, and the posterior part for a posterior lamellar keratoplasty procedure such as DSEK or DMEK. Our hemi- and quarter-DMEK techniques have further expanded the tissue supply: using these procedures, the same donor pool might theoretically provide tissue for up to five times the number of transplants.

Amnitrans EyeBank Rotterdam has initiated the elimination of sepsis as a general contra-indication for tissue donation in the Netherlands. Donors that suffer from sepsis at the time of death can now donate their corneas since there is no increased risk for the recipient.