A device to facilitate limbal stem cell procurement from eye bank donor tissue for keratolimbal allograft procedures.
OBJECTIVE
To develop a device that facilitates the procurement of corneal limbal stem cell grafts for keratolimbal allograft procedures used in the treatment of ocular surface disease associated with stem cell deficiency.


METHODS
Description of device design and technique for use.


METHODS
The device is composed of a pedestal with a convex surface mounted to a flat platform. A corneoscleral button placed endothelial side down and centrally upon the convexity is secured by suction conveyed through a hollowed core in the pedestal that connects to fenestrated openings on the convex surface. A donut-shaped stainless steel ring placed on tension by springs braces the peripheral tissue. A circular corneal incision is created of a desired thickness by a suction trephine, and a crescent blade is utilized to peripherally dissect a donut-shaped keratolimbal allograft.


RESULTS
This device facilitated the harvesting of the keratolimbal allograft tissue from four eye bank donor practice corneoscleral buttons and was then used to successfully procure grafts from six corneoscleral buttons used in three keratolimbal allograft procedures in three patients, one each with aniridia, alkali burn, and drug-induced limbal stem cell deficiency.


CONCLUSIONS
The described device effectively facilitates procurement of corneoscleral buttons for keratolimbal allograft procedures. It appears to offer advantages over freehanded techniques and previously described devices used for the same purpose.
Meisler
David M
DM
Cole Eye Institute, Department of Immunology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. meisled@ccf.org
Perez
Victor L
VL
Proudfit
James
J
D002469:Cell Separation / Q000295:instrumentation; D005125:Eye Banks; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000295:instrumentation* / Q000379:methods; D014184:Transplantation, Homologous