title: Postoperative Graft Thickness Obtained With Single-Pass Microkeratome-Assisted Ultrathin Descemet Stripping Automated Endothelial Keratoplasty.
abstract: OBJECTIVE
  To evaluate the results of microkeratome-assisted ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) using a nomogram developed for the single-pass technique.
  
  
  METHODS
  A retrospective study of eyes operated between September 2014 and March 2015 at Villa Serena-Villa Igea Private Hospitals (Forlì, Italy) by a single surgeon (M.B.). Study eyes underwent UT-DSAEK performed using a linear microkeratome-assisted lamellar dissection with disposable heads of different sizes (Moria ALTK system; Moria SA) chosen according to a pachymetry-based nomogram developed at our department. The main outcome measure was the graft thickness as assessed by means of anterior segment optical coherence tomography, measured between 1 and 3 months postoperatively.
  
  
  RESULTS
  Forty-two eyes were included in this study. Mean follow-up time was 5.0 ± 1.8 months (range 1.2-6.9 months). No perforation or other complication occurred during graft preparation. Mean postoperative central thickness of donor grafts was 63 ± 29 μm. Thickness ranged between 23 and 177 μm, and the second thickest graft measured 116 μm. By 3 months postoperatively, 41/42 (97%) of the grafts were of thickness ≤130 μm and 38/42 (90%) of the grafts were of central thickness ≤100 μm. The mean nasal-to-temporal absolute thickness difference at the graft's central 3-mm zone was 5 ± 7 μm at the last available measurement.
  
  
  CONCLUSIONS
  The nomogram developed at our institution allowed reliable single-pass microkeratome-assisted dissection of donor tissue, creating consistently thin and symmetric grafts without loss of tissue. The results obtained compare favorably with those reported in the past for double-pass microkeratome-assisted dissection of UT-DSAEK.
authors.affiliation: *Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Department of Ophthalmology, "Villa Igea" Hospital, Forlì, Italy; and §Istituto internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Nahum
authors.forename: Pia
authors.initials: P
authors.lastname: Leon
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
mesh_terms: D003316:Corneal Diseases / Q000601:surgery; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000295:instrumentation / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology*; D006801:Humans; D049451:Nomograms; D009929:Organ Size; D011184:Postoperative Period; D012189:Retrospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology