Thin lenticule Descemet's stripping automated endothelial keratoplasty: single, slow pass technique.
BACKGROUND
To evaluate the outcomes of single pass thin lenticule sutureless Descemet's stripping automated endothelial keratoplasty with donor lenticules prepared using a 400 μm microkeratome head.


METHODS
Interventional case series.


METHODS
Cases with corneal endothelial dysfunction.


METHODS
Fifteen cases with corneal endothelial dysfunction (eight pseudophakic bullous keratopathy, three Fuchs' endothelial dystrophy, three congenital hereditary endothelial dystrophy and one failed graft) underwent thin lenticule Descemet's stripping automated endothelial keratoplasty at a tertiary care hospital. Donor lenticule was prepared with a single pass 400 μm Carriazo Barraquer microkeratome (Moria, Antony, France) head. Sutureless Descemet's stripping automated endothelial keratoplasty was performed in all the cases through a 3.5 mm corneoscleral tunnel using a Busin glide for graft insertion.


METHODS
Main parameters evaluated were postoperative donor lenticule thickness and best-corrected visual acuity.


RESULTS
Donor lenticules were harvested successfully for all 15 cases without any complications. At 6-months follow up, the mean logMAR best-corrected visual acuity improved from 1.87 ± 0.52 to 0.109 ± 0.11 (P = < 0.0001). The mean donor lenticule thickness was 111 ± 17.62 μm (range 70-134 μm) at the last follow up. The mean endothelial cell loss was 26.33 ± 1.34%.


CONCLUSIONS
Thin donor lenticules for Descemet's stripping automated endothelial keratoplasty can be safely harvested using a single pass technique with 400 μm microkeratome head and can be used for a successful Descemet's stripping automated endothelial keratoplasty surgery.
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
Rasik B
RB
Vajpayee
Prafulla K
PK
Maharana
Shreyans
S
Jain
Namrata
N
Sharma
Vishal
V
Jhanji
D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D063171:Corneal Pachymetry; D003886:Descemet Membrane / Q000473:pathology; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D005125:Eye Banks / Q000379:methods; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D013048:Specimen Handling; D014019:Tissue Donors; D014792:Visual Acuity / Q000502:physiology
Descemet's stripping automated endothelial keratoplasty; endothelial keratoplasty: single; keratoplasty; slow pass technique; thin lenticule Descemet's stripping automated endothelial keratoplasty