Sinsky hook assisted roll preparation (SHARP): A modified technique for Descemet membrane endothelial keratoplasty donor preparation

PURPOSE: To describe a simple technique of sinsky hook assisted roll preparation (SHARP) for Descemet membrane endothelial keratoplasty (DMEK) donor preparation. METHODS: This experimental study was conducted at National Eye Bank, India with 40 optical grade human donor corneoscleral tissues found not suitable for surgery. 25 tissues were initially used to standardize the technique and remaining 15 for establishing the final technique. Donor corneal tissues were initially placed on a sterile Teflon block partially filled with tissue culture media. Initially, a partial thickness trephination was done followed by sinsky assisted 360° separation of the Descemet membrane (DM) from the underlying stroma (2 mm from the edge). The separation was further extended by 3–4 mm from the edge for 4–5 clock hours followed by bimanual peeling of the DM. This was followed by central 8 mm trephination. The primary outcome measures were a complete success (8 mm roll without peripheral edge tears) and partial success (8 mm roll with peripheral edge tears). RESULTS: DMEK roll was successfully peeled in 86.6% tissues (n = 13/15). Complete success was obtained in 66.6% tissues while partial success was obtained in 20% tissues. The median age of donor tissue was 45 years. The donor age of tissues, from which DMEK roll could not be obtained (2/12) was 15 days and 18 years. CONCLUSION: SHARP is a simple technique of DMEK that does not require any sophisticated instruments.