Eye bank survey of surgeons using precut donor tissue for descemet stripping automated endothelial keratoplasty.
OBJECTIVE
To assess surgeon satisfaction with precut corneal tissue from 1 eye bank for Descemet stripping automated endothelial keratoplasty (DSAEK). Surgical techniques and predictors of procedural success were also examined.


METHODS
A 19-question survey was completed by 53 surgeons around the United States for 197 DSAEK cases using prepared corneal allograft tissue from the Iowa Lions Eye Bank. Surgeries were performed between April 1 and December 31, 2006; surveys were completed retrospectively within a few weeks of surgery.


RESULTS
Tissue was found to be acceptable in 98% of DSAEK cases reported. Difficulties with precut tissue (eg, lack of anterior cap adherence to the posterior lamella, not visible or decentered central dot, anterior edge undermining) were reported in approximately 10% of cases. A rebubbling procedure was performed in 23% of cases for donor dislocations. The donor lenticule adhered, with resulting corneal deturgescence, in 86% of cases. Surgeons declared a successful procedure in 92% of cases. Of the 14 unsuccessful cases, donor tissue quality was the underlying etiology in only 1 case. Procedural success rates were related to surgeon experience (P = 0.002), lenticule adherence after only 1 anterior chamber air bubble (P = 0.005), no small perforations to release fluid (P = 0.005), and the presence of corneal deturgescence (P = 0.002).


CONCLUSIONS
The use of precut tissue for DSAEK is not associated with increased risk of complications related to tissue preparation. With standardization of precutting donor tissue, safety of DSAEK surgery may be improved while increasing surgeon efficiency.
Kitzmann
Anna S
AS
Department of Ophthalmology, University of Iowa, Iowa City, IA 52242, USA.
Goins
Kenneth M
KM
Reed
Cynthia
C
Padnick-Silver
Lissa
L
Macsai
Marian S
MS
Sutphin
John E
JE
D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005125:Eye Banks / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013048:Specimen Handling; D016896:Treatment Outcome