Endothelial damage by the corneal Hessburg-Barron vacuum trephine.
BACKGROUND
Tissue damage in corneal transplantation procedures was previously assessed in comparative pilot studies using vacuum-assisted metal blade trephines and a noncontact hydrogen fluoride laser trephine system. With the laser, endothelial damage was less than 20 x 30 microns at the edge of the posterior corneal perforation.


METHODS
In this study, a second generation vacuum-assisted Hessburg-Barron trephine was evaluated in full-thickness penetrating trephination performed in 16 rabbit eyes and eight fresh human donor eyes.


RESULTS
We found a relatively large, 150-micrometer wide, annular zone of endothelial damage on the recipient cornea located 1.25 mm away from the trephined opening. Our study demonstrates that endothelial damage is linked to the instrument's vacuum fixation ring.


CONCLUSIONS
With this trephine, endothelial damage may be avoided by using partial-depth trephination, filling the anterior chamber with viscoelastic and completing the procedure using a metal blade or diamond knife.
Legeais
J M
JM
Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
Parel
J M
JM
Simon
G
G
Ren
Q
Q
Denham
D
D
D000818:Animals; D002470:Cell Survival; D004728:Endothelium, Corneal / Q000293:injuries* / Q000473:pathology; D005131:Eye Injuries / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects* / Q000295:instrumentation; D011817:Rabbits; D013525:Surgical Instruments / Q000009:adverse effects*; D014343:Trypan Blue
D014343:Trypan Blue