title: Single-Pass Microkeratome System for Eye Bank DSAEK Tissue Preparation: Is Stromal Bed Thickness Predictable and Reproducible?
abstract: OBJECTIVE
  To evaluate the predictability and reproducibility of stromal bed thickness for single-pass donor Descemet stripping automated endothelial keratoplasty (DSAEK) tissue preparation, using the ML7 Microkeratome Donor Cornea System (Med-logics Inc, Athens, TX).
  
  
  METHODS
  In this retrospective chart review of 256 consecutive corneal tissue preparations for DSAEK surgery, from June 2013 to August 2014, tissue thicknesses were divided into 3 groups, depending on surgeon preference: <91 μm (group A), 90 to 120 μm (group B), and 120 to 160 μm (group C). Precut and postcut data were recorded.
  
  
  RESULTS
  Average postcut donor corneal thickness was 114 ± 30 μm (range 60-183 μm), whereas the average in group A was 97 ± 23 μm (range 60-128), in group B was 113 ± 21 μm (range 77-179), and in group C was 134 ± 43 (range 89-183). Average postcut endothelial cell density was very adequate at 3013 ± 250 cells per square millimeter. There were a total of 7 failed procedures from 256 attempts, which represents a rate of 2.7%. This rate decreases to 1.5% when analyzing the last 200 cuts.
  
  
  CONCLUSIONS
  The ML7 Microkeratome Donor Cornea System allows for reliable and reproducible DSAEK tissue preparation. Ultrathin DSAEK tissues can be prepared with a single-pass. Aiming for a graft thickness between 90 and 120 μm seems to be most reliable.
authors.affiliation: *Department of Ophthalmology and Visual Science, University of California Davis, Sacramento, CA; and †Sierra Donor Services Eye Bank, Sacramento, CA.
authors.forename: Mazen Y
authors.initials: MY
authors.lastname: Choulakian
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Li
authors.forename: Samuel
authors.initials: S
authors.lastname: Ramos
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mannis
mesh_terms: D002452:Cell Count; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery*; D003319:Corneal Stroma / Q000166:cytology*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004867:Equipment Design; D005125:Eye Banks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000295:instrumentation*; D041623:Tomography, Optical Coherence