{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:39:14Z","timestamp":1787009954940,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Purpose:<\/jats:title>\n Descemet membrane endothelial keratoplasty (DMEK) donor grafts can be safely trifolded, preloaded, and shipped for up to 96 hours without significant endothelial cell loss; however, clinical outcomes of such storage times have yet to be reported in human patients. Here, we report a case of a trifolded, preloaded DMEK graft stored for 96 hours and transplanted in a 68-year-old woman with Fuchs endothelial dystrophy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n DMEK graft was preloaded and trifolded with postprocessing endothelial cell density of 2558 cells\/mm\n 2<\/jats:sup>\n . Intraoperatively, it was pulled into the anterior chamber with 27-G irrigating forceps, opened as a sheet, and was positioned without complication using SF\n 6<\/jats:sub>\n gas with 80% fill. The graft was attached at all postoperative day visits including day 1, 5, and week 6.\n <\/jats:p>\n <\/jats:sec>\n \n Result:<\/jats:title>\n \n At the 1 week postoperative visit, the DMEK graft was fully attached with clear cornea, and the patient's vision had improved from counting fingers to 20\/60. Specular microscopy resulted in endothelial cell density of 1930 cells\/mm\n 2<\/jats:sup>\n (endothelial cell loss of 22.8%). At the 6 week postoperative visit, central pachymetry improved from 530 microns preoperatively to 493.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n We demonstrate feasibility of DMEK with a preloaded and trifolded graft stored for 96 hours, with resolution of corneal edema. These results underscore the viability of international shipment and optimized resource distribution of donor tissue where there is a high global need for DMEK grafts.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/ebct.0000000000000036","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T11:00:56Z","timestamp":1744887656000},"page":"e0036","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of Descemet Membrane Endothelial Keratoplasty With Preloaded and Trifolded Graft After 96-Hour Storage and Shipping"],"prefix":"10.1097","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4326-4757","authenticated-orcid":false,"given":"Tara","family":"Srinivas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen O.","family":"Eghrari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6]]},"reference":[{"key":"R2-20250417","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1097\/ICO.0000000000001974","article-title":"Safety of long-term storage and shipping of prestripped, prestained, and preloaded Descemet membrane endothelial keratoplasty tissue","volume":"38","author":"Hooton","year":"2019","journal-title":"Cornea"},{"key":"R3-20250417","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.ajo.2018.06.013","article-title":"Clinical outcomes of preloaded Descemet membrane endothelial keratoplasty grafts with endothelium tri-folded inwards","volume":"193","author":"Busin","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"R4-20250417","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1097\/ICO.0000000000002298","article-title":"Preloading trifolded grafts for Descemet membrane endothelial keratoplasty affects scroll formation","volume":"39","author":"Solar","year":"2020","journal-title":"Cornea"},{"key":"R5-20250417","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.ajo.2022.03.009","article-title":"Factors affecting the success rate of preloaded Descemet membrane endothelial keratoplasty with endothelium-inward technique: a multicenter clinical study","volume":"241","author":"Parekh","year":"2022","journal-title":"Am J Ophthalmol"},{"key":"R6-20250417","doi-asserted-by":"crossref","first-page":"e000546","DOI":"10.1136\/bmjophth-2020-000546","article-title":"Clinical outcomes of pre-loaded ultra-thin DSAEK and pre-loaded DMEK","volume":"5","author":"Romano","year":"2020","journal-title":"BMJ Open Ophthalmol"},{"key":"R7-20250417","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/aos.13162","article-title":"Endothelium-in versus endothelium-out for Descemet membrane endothelial keratoplasty graft preparation and implantation","volume":"95","author":"Parekh","year":"2017","journal-title":"Acta Ophthalmol"},{"key":"R8-20250417","doi-asserted-by":"crossref","first-page":"e000679","DOI":"10.1136\/bmjophth-2020-000679","article-title":"Viability of preloaded Descemet membrane endothelial keratoplasty grafts with 96-hour shipment","volume":"6","author":"Chen","year":"2021","journal-title":"BMJ Open Ophthalmol"},{"key":"R9-20250417","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1001\/jamaophthalmol.2015.4776","article-title":"Global survey of corneal transplantation and eye banking","volume":"134","author":"Gain","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"R10-20250417","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1097\/ICO.0000000000002648","article-title":"Techniques, outcomes, and complications of preloaded, trifolded Descemet membrane endothelial keratoplasty using the DMEK EndoGlide","volume":"40","author":"Ighani","year":"2021","journal-title":"Cornea"},{"key":"R11-20250417","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1038\/s41598-020-58700-5","article-title":"Optimisation of storage and transportation conditions of cultured corneal endothelial cells for cell replacement therapy","volume":"10","author":"Wahlig","year":"2020","journal-title":"Sci Rep"},{"key":"R12-20250417","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/ICO.0000000000002862","article-title":"Effect of Descemet membrane endothelial keratoplasty graft storage time on graft elasticity","volume":"41","author":"Shilova","year":"2022","journal-title":"Cornea"}],"container-title":["Eye Banking and Corneal Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/ebct.0000000000000036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T11:00:58Z","timestamp":1744887658000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ebct.0000000000000036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/ebct.0000000000000036","relation":{},"ISSN":["2833-7018"],"issn-type":[{"value":"2833-7018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]},"assertion":[{"value":"2024-12-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}