Preparation of ultrathin grafts for Descemet-stripping endothelial keratoplasty with a single microkeratome pass.
We present a technique to achieve ultrathin Descemet-stripping automated endothelial keratoplasty (DSAEK). Using a simple method of controlling artificial anterior chamber pressure and drying the corneal surface, it was possible to thin the donor cornea at a rate of 11 μm a minute. When the donor cornea was between 500 μm and 510 μm, a single pass was made using a 350 μm microkeratome head followed by a peripheral dissection. The resulting mean graft thickness was 83.2 μm ± 14.9 (SD) (range 50 to 98 μm) with a mean peripheral graft edge thickness of 106.8 ± 10.9 μm (range 90 to 120 μm). There were no surgical complications, and all grafts remained attached. This is a reliable method for preparing ultrathin donor corneal lenticules for DSAEK in the operating room or eye bank without using multiple microkeratome heads or risking double passes.
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria. Electronic address: vito.romano@gmail.com.
Vito
V
Romano
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
Bernhard
B
Steger
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
Jayavani
J
Myneni
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
Mark
M
Batterbury
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
Colin E
CE
Willoughby
From the Department of Corneal and External Eye Diseases (Romano, Myneni, Batterbury, Willoughby, Kaye), St. Paul's Eye Unit, Royal Liverpool University Hospital, and the Department of Eye and Vision Science (Willoughby, Kaye), University of Liverpool, Liverpool, United Kingdom; the Department of Ophthalmology (Steger), Medical University of Innsbruck, Innsbruck, Austria.
Stephen B
SB
Kaye
D000368:Aged; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000000981:diagnostic imaging / Q000637:transplantation*; D006801:Humans; D008875:Middle Aged; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D041623:Tomography, Optical Coherence