title: "OSMO-UT-DSAEK" using THIN-C medium.
abstract: BACKGROUND
  When performing ultra-thin Descemet's stripping automated endothelial keratoplasty (UT-DSAEK), the quality of the stromal interface and stromal thickness seem to be critical for visual outcome. The aim of this study was to investigate whether additional osmotic deswelling prior to UT-DSAEK improves the quality of the cut surface and leads to a more reliable and deeper cut in UT-DSAEK ("OSMO-UT-DSAEK").
  
  
  METHODS
  Seventeen human donor corneas not usable for transplantation were used in this experiment. After standard deswelling with culture Medium II, ten corneas were randomly assigned to be additionally deswollen within THIN-C medium. The other remaining seven corneas were put back into culture Medium II. All corneas were placed in an artificial anterior chamber system (Moria); a double path cutting procedure using a microkeratome (Moria) was then performed. Corneal thickness was measured by ultrasound biomicroscopy and in paraffin-embedded slides, followed by histological grading of the cut surface.
  
  
  RESULTS
  Stromal interface smoothness significantly improved after preconditioning in THIN-C medium (Pearson P = 0.019). The correlation of the corneal thickness obtained by UBM (mean 706 ± SD 208 μm) and histology (mean 530 ± SD 159 μm) was not significant (Pearson r = 0.11, P > 0.05, mean difference 247, 95 % CI [+50;+304]). We found no significant correlation between the microkeratome setting and the actual thickness of the lenticule measured in histological analysis in both media as well as for the first and second cut (first cut: Pearson r = 0.9, P = 0.1, 95 % CI [-10;+96], second cut: Pearson r = 0.9, P = 0.4, 95 % CI [-10;+22]).
  
  
  CONCLUSIONS
  Preconditioning of corneas with THIN-C medium significantly improved the quality of the graft interface in UT-DSAEK, but did not significantly improve the cut precision of the microkeratome.
authors.affiliation: Department of Ophthalmology, University of Cologne, Kerpenerstraße 62, 50924, Cologne, Germany, franziska.bucher@uk-koeln.de.
authors.forename: F
authors.initials: F
authors.lastname: Bucher
authors.forename: S
authors.initials: S
authors.lastname: Roters
authors.forename: A
authors.initials: A
authors.lastname: Mellein
authors.forename: D
authors.initials: D
authors.lastname: Hos
authors.forename: L M
authors.initials: LM
authors.lastname: Heindl
authors.forename: C
authors.initials: C
authors.lastname: Cursiefen
authors.forename: M
authors.initials: M
authors.lastname: Hermann
mesh_terms: D003315:Cornea / Q000000981:diagnostic imaging / Q000187:drug effects*; D016895:Culture Media, Serum-Free / Q000494:pharmacology*; D003886:Descemet Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D003911:Dextrans / Q000494:pharmacology*; D004728:Endothelium, Corneal / Q000000981:diagnostic imaging / Q000473:pathology; D005125:Eye Banks; D006801:Humans; D033401:Microscopy, Acoustic; D009924:Organ Culture Techniques; D009997:Osmotic Pressure / Q000187:drug effects* / Q000502:physiology; D014019:Tissue Donors; D041623:Tomography, Optical Coherence
chemical_list: D016895:Culture Media, Serum-Free; D003911:Dextrans
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