Descemet stripping automated endothelial keratoplasty tissue preparation with femtosecond laser and contact lens.
OBJECTIVE
To report a novel method of preparing planar Descemet stripping automated endothelial keratoplasty (DSAEK) tissue using a femtosecond laser with a hyperopic soft contact lens (Hyp-SCL).


METHODS
DSAEK tissue was prepared from 11 cadaveric porcine eyes. A femtosecond laser was used to create 400-microm flaps, with or without a Hyp-SCL, after which the eyes were imaged with anterior segment optical coherence tomography. The ratio of the mean central thickness (C) to the mean peripheral thickness (P) was calculated using the flap tool.


RESULTS
Eleven eyes were cut (5 without, 5 with, and 1 without and with a Hyp-SCL). In all corneas, the cut interfaces were visualized by anterior segment optical coherence tomography. The mean C:P ratio of the flap made without a Hyp-SCL was 0.998 (range 0.968-1.03, SD = 0.254) compared with 0.904 (range 0.851-0.985, SD = 0.509) with a Hyp-SCL (P = 0.001), demonstrating that a cut made with a Hyp-SCL created a flap that was significantly more concave than that created without a Hyp-SCL, resulting in a more planar DSAEK graft. However, the C:P ratios calculated for DSAEK tissue made without (mean 0.998, range 0.965-1.02, SD = 0.0195) and with (mean 1.02, range 0.986-1.05, SD = 0.0250) a Hyp-SCL did not show significance (P = 0.07).


CONCLUSIONS
Combining a femtosecond laser and a Hyp-SCL may aid in the creation of planar donor tissue for DSAEK. Clinically, this could reduce the amount of postoperative hyperopic shift, although further human corneal studies are warranted.
Ide
Takeshi
T
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Yoo
Sonia H
SH
Kymionis
George D
GD
Leng
Theodore
T
Marini
Cecilia
C
Stanciu
Natalie A
NA
O'Brien
Terrence P
TP
D000818:Animals; D003263:Contact Lenses, Hydrophilic; D057111:Descemet Stripping Endothelial Keratoplasty; D053685:Laser Therapy / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D013552:Swine; D041623:Tomography, Optical Coherence