Preparation of ultrathin grafts for Descemet-stripping endothelial keratoplasty with a single microkeratome pass

We present a technique to achieve ultrathin Descemet-stripping automated endothelial keratoplasty (DSAEK). Using a simple method of controlling artificial anterior chamber pressure and drying the corneal surface, it was possible to thin the donor cornea at a rate of 11 μm a minute. When the donor co...

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Bibliographic Details
Published in:Journal of cataract and refractive surgery Vol. 43; no. 1; p. 12
Main Authors: Romano, Vito, Steger, Bernhard, Myneni, Jayavani, Batterbury, Mark, Willoughby, Colin E, Kaye, Stephen B
Format: Journal Article
Language:English
Published: United States 01.01.2017
Subjects:
Aged
Cell Count
Corneal Diseases - surgery
Descemet Stripping Endothelial Keratoplasty - methods
Endothelium, Corneal - diagnostic imaging
Endothelium, Corneal - transplantation
Humans
Middle Aged
Tissue and Organ Harvesting - methods
Tissue Donors
Tomography, Optical Coherence
ISSN:1873-4502, 1873-4502
Online Access:Get more information
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Summary:We present a technique to achieve ultrathin Descemet-stripping automated endothelial keratoplasty (DSAEK). Using a simple method of controlling artificial anterior chamber pressure and drying the corneal surface, it was possible to thin the donor cornea at a rate of 11 μm a minute. When the donor cornea was between 500 μm and 510 μm, a single pass was made using a 350 μm microkeratome head followed by a peripheral dissection. The resulting mean graft thickness was 83.2 μm ± 14.9 (SD) (range 50 to 98 μm) with a mean peripheral graft edge thickness of 106.8 ± 10.9 μm (range 90 to 120 μm). There were no surgical complications, and all grafts remained attached. This is a reliable method for preparing ultrathin donor corneal lenticules for DSAEK in the operating room or eye bank without using multiple microkeratome heads or risking double passes.
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ISSN:1873-4502
1873-4502
DOI:10.1016/j.jcrs.2016.12.009