Influence of Pre-Descemet´s Layer in Precut Endothelial Grafts Digital Measurements and Scrolling Characteristics

Purpose: This study aims to evaluate the impact of the pre-Descemet layer on central graft width (CGW) and scrolling scores (SS) in endothelial keratoplasty. Methods: This ex-perimental study included 47 corneoscleral buttons unsuitable for transplantation dissected by intrastromal air injection into pre-Descemet´s endothelial keratoplasty (PDEK) or Descemet´s membrane endothelial keratoplasty (DMEK) grafts. The central graft width (CGW) was calculated using FIJI-ImageJ software, SS characteristics was determined. The Student's “t-test” analyzed paired samples. Pearson´s correlation coefficients were calcu-lated for CGW and age, and statistical significance was set at P < 0.05. Using confocal mi-croscopy a representative PDEK graft had endothelial cell pool analyzed with vital dies. Results: The average age was 53.8±14.5 years and 18 were male (66.6%). Twenty-four PDEK grafts (51%) and 17 DMEK grafts (36.2%) were dissected. Six dissections (12.8%) failed, three (50%) were diabetic donors (P< 0.001). Mean CGW of 2.35 mm for PDEK grafts, had higher values than DMEK with mean of 1.95 mm (P< 0.05). The R2 correlation of age and CGW was 0.2834 and 0.004 for DMEK and PDEK, respectively. The PDEK grafts were SS-2 (50%) and the DMEK grafts were SS-3 (70.5%). TB had no significant effect on CGW or SS. Conclusion: PDEK had a significantly higher CGW than DMEK (P< 0.05), and there was an inverse rela-tionship between CGW and SS. Donor age and CGW had a weak correlation with DMEK, and no correlation with PDEK grafts.