title: Femtosecond laser and microkeratome-assisted Descemet stripping endothelial keratoplasty: first clinical results.
abstract: OBJECTIVE
  To perform Descemet stripping automated endothelial keratoplasty (DSAEK) using a novel technique to obtain very thin (<100 µm) posterior corneal disks.
  
  
  METHODS
  Twenty five DSAEK grafts were prepared with two sequential cuts: the first cut, of variable thickness, was made with a femtosecond laser and the second with a 300 µm microkeratome head. Spectacle corrected visual acuity, endothelial cell density evaluation with specular microscopy and anterior segment optical coherence tomography to measure central and peripheral graft thickness was performed preoperatively and postoperatively at 1, 3 and 6 months.
  
  
  RESULTS
  There were no irregular cuts or perforations during tissue preparation. Central graft thickness was 79.6 µm (SD ± 14.5; range 54-98) and 69.3 µm (SD ± 14.2; range 49-96) at 3 and 6 months. Corrected distance visual acuity improved from 0.91 logMAR preoperatively to 0.11 logMAR at 6 months. Donor endothelial cells averaged 2675 cells/mm(2) preoperatively and 1729 cells/mm(2) at 6 months. There were no graft detachments.
  
  
  CONCLUSIONS
  This new technique consistently yielded very thin grafts (<100 µm), excellent visual acuity results and good endothelial cell counts. No donor tissue was wasted.
authors.affiliation: Ophthalmology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal.
authors.forename: Andreia Martins
authors.initials: AM
authors.lastname: Rosa
authors.forename: Maria Fátima
authors.initials: MF
authors.lastname: Silva
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Quadrado
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Costa
authors.forename: Inês
authors.initials: I
authors.lastname: Marques
authors.forename: Joaquim Neto
authors.initials: JN
authors.lastname: Murta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity
keywords: Cornea; Treatment Surgery