title: Gebauer SLc Original and Moria One-Use Plus automated microkeratomes for ultrathin Descemet's stripping automated endothelial keratoplasty preparation.
abstract: OBJECTIVE
  We compared the SLc Original (SLc) and One-Use Plus (OUP) microkeratomes for ultrathin Descemet's stripping automated endothelial keratoplasty (DSAEK) lamella preparation and storage, vis-à-vis accuracy, endothelial cell loss (ECL) and lamellar surface roughness (LSR).
  
  
  METHODS
  Twenty-five human corneas were dissected with single-use heads of different sizes aiming for a posterior lamella (PL) thickness of 85 μm, after which they were incubated for 6 days in a 5% dextran medium. Before preparation (0 hr) and 1, 24, and 144 hr after dissection, ECL and corneal thickness (CCT) were measured by ultrasound pachymetry (USP) and optical coherence tomography (OCT). Lamellar surface roughness (LSR) was assessed by scanning electron microscopy (SEM) and evaluated by two masked observers.
  
  
  RESULTS
  Prior to cutting, CCTs did not differ between OCT and USP measurements, with a high correlation between the two modalities (r2= 0.8; p < 0.0001). Both systems succeeded in UT lamella preparation (CCT 40-130 μm) in 88% of cases. The OUP heads cut significantly deeper than the according SLc counterparts (p = 0.001), while the variance did not differ. The mean PL thickness increased significantly in the following incubation period (p = 0.01) with no difference between the keratome groups. Endothelial cell density (ECD) decreased significantly from before to 1 hr after preparation (-5.6%; p = 0.04), with no changes in the following 144-hr incubation period and no differences between the OUP and SLc group. Lamellar surface roughness (LSR) did not differ between both systems.
  
  
  CONCLUSIONS
  The SLc and the OUP system are both suited for the preparation of UT-DSAEK lamellae. Neither system differed significantly in variability, LSR or ECL, which did not increase during a 6-day incubation period.
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Fuest
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Salla
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hermel
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Wolfgang Joachim
authors.initials: WJ
authors.lastname: Plum
authors.affiliation: Department of Electron Microscopy, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Rütten
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Plange
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Kuerten
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Anne Christine
authors.initials: AC
authors.lastname: Schnitzler
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Walter
mesh_terms: D000368:Aged; D002452:Cell Count; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty / Q000295:instrumentation*; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D014019:Tissue Donors; D014021:Tissue Preservation; D020858:Tissue and Organ Harvesting / Q000379:methods*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
keywords: Descemet's stripping automated endothelial keratoplasty; corneal transplantation; lamellar graft; organ culture