@article {1089,
	title = {Posterior lamellar keratoplasty using descemetorhexis and organ-cultured donor corneal tissue (Melles technique)},
	journal = {Cornea},
	volume = {25},
	year = {2006},
	note = {Nieuwendaal, Carla P Lapid-Gortzak, Ruth van der Meulen, Ivanka J Melles, Gerrit J R United States Cornea Cornea. 2006 Sep;25(8):933-6.},
	month = {Sep},
	pages = {933 - 6},
	edition = {39036},
	abstract = {PURPOSE: To report the clinical results of posterior lamellar keratoplasty (PLK) using predissected organ-cultured donor corneal tissue implanted after stripping of the Descemet membrane. METHODS: Twenty-two eyes of 22 patients in whom a PLK procedure was performed for pseudophakic bullous keratopathy and/or Fuchs endothelial dystrophy were evaluated. In all eyes, the recipient Descemet membrane was excised by performing a descemetorhexis. Just after harvesting the donor tissue, each cornea had a posterior lamellar dissection made at approximately 80\% stromal depth, and each cornea was preserved in an organ culture system for 10 to 21 days. During surgery, a posterior lamellar disk was trephinated from the predissected donor cornea and inserted through a 5.0-mm scleral incision into the anterior chamber of the recipient by folding the donor. Specular microscopy was performed at 6, 12, and 18 months to measure the endothelial cell density. RESULTS: In 3 eyes (14\%), the posterior donor disk did not attach to the recipient posterior stroma, so a penetrating keratoplasty was performed in a secondary procedure. The transplants in the remaining 19 eyes cleared and maintained clarity throughout the follow-up period. In these eyes, best corrected visual acuity (BCVA) ranged from 0.25 to 1.0 up to 27 months of follow-up. Postoperative astigmatism averaged 1.7 +/- 1.0 D. Endothelial cell density averaged 1650 +/- 390 cells/mm at 6 months, 1560 +/- 350 cells/mm at 12 months, and 1500 +/- 430 cells/mm at 24 months. Two eyes developed mild interface haze. CONCLUSION: PLK can be performed using an organ-cultured donor posterior disk. Visual rehabilitation may be slower than in PLK with fresh donor tissue.},
	keywords = {Aged, Aged, 80 and over, Cell Count, Corneal Transplantation / *methods, Cryopreservation, Descemet Membrane / *surgery, Endothelium, Corneal / pathology / *surgery, Female, Fuchs{\textquoteright} Endothelial Dystrophy / surgery, Humans, Male, Middle Aged, Organ Culture Techniques, Tissue Donors, Tissue Preservation, Treatment Outcome, Visual Acuity / physiology},
	issn = {0277-3740 (Print) 0277-3740 (Linking)},
	doi = {10.1097/01.ico.0000239002.92989.1a 00003226-200609000-00014 [pii]},
	author = {Nieuwendaal,C. P. and Lapid-Gortzak,R. and van der Meulen,I. J. and Melles,G. J.}
}
