Precut tissue in Descemet's stripping automated endothelial keratoplasty donor characteristics and early postoperative complications.
OBJECTIVE
To describe donor characteristics of eye bank-prepared precut tissue used in Descemet's stripping automated endothelial keratoplasty (DSAEK) and report any increase in immediate postoperative complications associated with its use.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
One hundred donor corneas deemed appropriate for transplant and 100 eyes undergoing DSAEK for endothelial dysfunction.


METHODS
Precut donor tissue was evaluated in a prospective study of 100 consecutive cases of DSAEK surgery. Donor characteristics and the immediate postoperative complications of donor tissue dislocation and graft failure with the use of precut tissue were recorded and analyzed.


METHODS
Preoperative donor characteristics (age, time from death to preservation, time from death to implantation, time from cut to implantation, residual stromal bed thickness, pre- and postcut endothelial density), rate of dislocation, and rate of primary graft failure.


RESULTS
Average donor age was 57.6+/-10.8 years, average time from death to preservation was 9.8+/-3.2 hours, average time from death to implantation was 94.5+/-33.5 hours, and average time from cut to implantation was 26.0+/-17.4 hours. The average residual stromal bed thickness was 169+/-36 microns. The average endothelial cell density (ECD) after cutting was 2709+/-292 cells/mm(2) (n = 100). In the subgroup of donors in whom pre-resection and postresection endothelial cell densities were available (n = 80), the average ECD before cutting was 2743+/-253 cells/mm(2) and the average ECD after cutting was 2644+/-257 cells/mm(2). This average cell loss of 3.7% was statistically significant (P<0.001). There was only 1 dislocation in this entire series of 100 eyes. There were no primary graft failures.


CONCLUSIONS
The use of precut tissue in DSAEK had a low rate of early postoperative complications such as graft dislocation (1%) and primary graft failure (0%). A wide range of donor characteristics such as donor age, death to transplantation time, precutting to transplantation time, and donor lenticule thickness resulted in excellent adhesion of the tissue and clear grafts.
Chen
Edwin S
ES
Devers Eye Institute, Portland, Oregon 97210, USA.
Terry
Mark A
MA
Shamie
Neda
N
Hoar
Karen L
KL
Friend
Daniel J
DJ
D000328:Adult; D000368:Aged; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005125:Eye Banks; D016591:Histocytological Preparation Techniques; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods*; D013997:Time Factors; D014019:Tissue Donors