Bedard P, et al. - Researchers conducted this prospective study to describe the pattern and factors affecting endothelial cell loss (ECL) in pre-Descemet endothelial keratoplasty (PDEK) graft preparation. Donor corneas were randomized to inflation with air vs Optisol GS storage media. PDEK preparation was conducted under continuous pressure monitoring. They prospectively tested 25 corneas. No difference was found in peak inflation pressure or mean expansion pressure between air (706.0, 510.7 mmHg) and Optisol GS (852.9, 653.0 mmHg). Increasing donor age and decreasing preservation time were linked to increased rates of acceptable endothelium. Findings suggested that PDEK processing may result in a reticular pattern of ECL. Higher inflation pressures are related to greater ECL. For PDEK, older donor tissues with shorter preservation times could be preferable.