title: Comparative study of descemet stripping automated endothelial keratoplasty donor preparation by Moria CBm microkeratome, horizon microkeratome, and Intralase FS60.
abstract: OBJECTIVE
  To evaluate the quality of stromal bed and the safety on endothelium in preparation of donor tissue for Descemet stripping automated endothelial keratoplasty in a masked fashion using 2 mechanical microkeratomes and a femtosecond laser.
  
  
  METHODS
  Deep anterior lamellar dissection was performed on 15 donor corneas. Central endothelial cell density was calculated using specular microscopy before and after the dissection. One cornea from each of 5 donor pairs was cut with the Moria ALTK system with the CBm microkeratome using the 300-μm head and the mate cut with the Horizon disposable 300-μm microkeratome. Five additional donor corneas were cut with the Intralase 60-kHz FS laser. The donor corneas were then bisected with half of the cornea used for Live/Dead assay to study central endothelial viability. The other halves were sent for scanning electron microscopy of the stromal bed. Qualitative surface roughness of the scanning electron microscopy images was graded by 2 masked observers, and quantitative surface roughness was assessed using roughness evaluation software.
  
  
  RESULTS
  The Horizon group showed a smoother stromal bed compared with the Moria or Intralase groups by 2 masked observers. However, the Moria group had the smoothest quantitative score of all the groups when assessed by roughness evaluation software. There was no statistically significant difference among the 3 groups in the percentage change in the central endothelial cell density or percentage of viable central endothelium by Live/Dead assay after the dissection.
  
  
  CONCLUSIONS
  Both mechanical microkeratomes created smoother stromal bed dissections than the femtosecond laser. All systems provided good endothelial cell viability.
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA. vinod.mootha@utsouthwestern.edu
authors.forename: V Vinod
authors.initials: VV
authors.lastname: Mootha
authors.forename: Ellen
authors.initials: E
authors.lastname: Heck
authors.forename: Steven M
authors.initials: SM
authors.lastname: Verity
authors.forename: W Matthew
authors.initials: WM
authors.lastname: Petroll
authors.forename: Neema
authors.initials: N
authors.lastname: Lakshman
authors.forename: Orkun
authors.initials: O
authors.lastname: Muftuoglu
authors.forename: R Wayne
authors.initials: RW
authors.lastname: Bowman
authors.forename: James P
authors.initials: JP
authors.lastname: McCulley
authors.forename: H Dwight
authors.initials: HD
authors.lastname: Cavanagh
mesh_terms: D000368:Aged; D002452:Cell Count; D003319:Corneal Stroma / Q000648:ultrastructure*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000295:instrumentation* / Q000379:methods; D004728:Endothelium, Corneal / Q000648:ultrastructure*; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation; D054018:Lasers, Excimer; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009926:Organ Preservation; D011786:Quality Control; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*