title: Descemet stripping automated endothelial keratoplasty tissue preparation with femtosecond laser and contact lens.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ide
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Theodore
authors.initials: T
authors.lastname: Leng
authors.forename: Cecilia
authors.initials: C
authors.lastname: Marini
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Stanciu
authors.forename: Terrence P
authors.initials: TP
authors.lastname: O'Brien
mesh_terms: 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