{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:05:30Z","timestamp":1780052730556,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Purpose: To evaluate the biomechanical impact of the Pre-Descemet\u2019s Layer (PDL) on central graft width (CGW) and Scrolling Score (SS) using a standardized digital morphometric approach in pre-Descemet endothelial keratoplasty (PDEK) and Descemet membrane endothelial keratoplasty (DMEK) grafts. Methods: This experimental study analyzed 47 donor corneoscleral buttons. Grafts were prepared via pneumatic dissection into PDEK or DMEK. CGW and SS were quantified using FIJI-ImageJ software from standardized video frames. Statistical analysis included Student\u2019s t-tests, Pearson\u2019s correlation, and Chi-Square tests. Endothelial viability and global integrity were assessed in representative PDEK grafts using confocal microscopy with triple vital staining (Hoechst 33342, Ethidium-homodimer, and Calcein-AM). Results: Forty-one grafts were successfully prepared (24 PDEK; 17 DMEK). The failure rate was significantly higher in diabetic donors (50% vs. 7.3% in non-diabetics, p &lt; 0.001). PDEK grafts exhibited a significantly higher mean CGW (2.35 \u00b1 0.36 mm) compared to DMEK (1.95 \u00b1 0.41 mm; p &lt; 0.05). A clear inverse relationship was established between CGW and SS; SS-2 was predominant in PDEK (50%), while SS-3 prevailed in DMEK (70.5%). Donor age showed a weak correlation with CGW in DMEK (R2 = 0.283) and no correlation in PDEK (R2 = 0.0004). Trypan blue staining did not significantly alter CGW or SS in either group (p &gt; 0.05). Confocal microscopy confirmed high endothelial viability (2407 cells\/mm2) with minimal iatrogenic damage in tissue folds. Conclusions: Retention of the PDL significantly reduces endothelial graft scrolling and increases CGW values in PDEK compared with DMEK. Although donor age demonstrated a weak association with CGW in DMEK grafts, no such relationship was observed in PDEK. Digital morphometric analysis represents a reproducible approach for preoperative characterization of graft behavior in eye banks.<\/jats:p>","DOI":"10.3390\/diagnostics16111660","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"1660","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retention of the Pre-Descemet\u2019s Layer Reduces Endothelial Graft Scrolling: Digital Morphometric Analysis of Precut Endothelial Grafts"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8883-299X","authenticated-orcid":false,"given":"Rodrigo B.","family":"Prado","sequence":"first","affiliation":[{"name":"Surgical Clinic Department, Universidade Estadual de Londrina, Londrina 86057-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6978-7505","authenticated-orcid":false,"given":"Sergio M.","family":"Borghi","sequence":"additional","affiliation":[{"name":"Pathological Science Department, Universidade Estadual de Londrina, Londrina 86057-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula M. T.","family":"Oguido","sequence":"additional","affiliation":[{"name":"Surgical Clinic Department, Universidade Estadual de Londrina, Londrina 86057-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-9283","authenticated-orcid":false,"suffix":"Jr.","given":"Waldiceu A.","family":"Verri","sequence":"additional","affiliation":[{"name":"Pathological Science Department, Universidade Estadual de Londrina, Londrina 86057-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio Marcelo B.","family":"Casella","sequence":"additional","affiliation":[{"name":"Surgical Clinic Department, Universidade Estadual de Londrina, Londrina 86057-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.jcrs.2008.05.036","article-title":"Donor tissue preparation for Descemet membrane endothelial keratoplasty","volume":"34","author":"Lie","year":"2008","journal-title":"J. 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