Postmortem Ultrastructural Analysis of a Cornea Transplanted With Descemet Membrane Endothelial Keratoplasty

Purpose: The aim of this study was to describe the ultrastructure of the host-donor interface in the eye of a recently deceased patient, who had undergone Descemet membrane endothelial keratoplasty. Methods: The eye was enucleated postmortem, and after standard decontamination, the corneoscleral button was excised, cut into 4 quadrants, and processed for light and transmission electron microscopy evaluation. Results: Transmission electron microscopy revealed close attachment of the donor's Descemet membrane to the host's stroma and projection of stromal collagen fibers into the interfacial matrix, resembling a normal "virgin" corneal architecture. Conclusions: Ultrastructurally, an attached Descemet membrane endothelial keratoplasty graft closely resembles that of an unoperated, healthy eye with no appreciable adventitious or missing structures.