Corneal lenticule harvest using a microkeratome and an artificial anterior chamber system at high intrachamber pressure

Li Li, Ashley Behrens, Paula M. Sweet, Kathryn E. Osann, Roy S. Chuck

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the safety and accuracy of a manual microkeratome and an artificial anterior chamber used at high intrachamber pressure to harvest corneal lenticules for lamellar keratoplasty. Setting: Department of Ophthalmology, University of California, Irvine, California, USA. Methods Forty-seven human eye-bank corneoscleral rims were mounted on an artificial anterior chamber. A manual microkeratome was used to perform lamellar keratectomy at a mean intrachamber pressure of 95.8 mm Hg ± 4.8 (SD). Two thicknesses (300 μm and 360 μm microkeratome heads) and diameters (8.0 mm and 9.0 mm) were attempted, and the resultant lenticules were analyzed by pachymetry and digital photography. Results: In the 9.0 mm/360 μm group, corneal perforation occurred in 12 of 17 lenticules (71.2%). Except for this group, 24 of 30 corneas (80.0%) showed a less than 0.5 mm deviation from the expected diameter. Neither the horizontal nor the vertical diameter differences were statistically significant (P > .05). The difference between the horizontal and vertical diameters was within ± 0.2 mm in 23 corneas (76.7%). Three (10.0%) corneal beds contained a slightly uneven keratectomy margin. Conclusions: This system provided accurate and smooth lenticules for lamellar keratoplasty. The precision and accuracy of the obtained corneal lenticules were better than those in previous reports. However, the 9.0 mm diameter/360 μm thickness head with high intrachamber pressure should not be applied in the clinical setting without further testing. In this laboratory study, a minimal corneal thickness of 588 μm was required to avoid perforation.

Original languageEnglish (US)
Pages (from-to)860-865
Number of pages6
JournalJournal of Cataract and Refractive Surgery
Volume28
Issue number5
DOIs
StatePublished - 2002
Externally publishedYes

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Anterior Chamber
Corneal Transplantation
Pressure
Cornea
Head
Eye Banks
Corneal Perforation
Photography
Ophthalmology
Safety

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Corneal lenticule harvest using a microkeratome and an artificial anterior chamber system at high intrachamber pressure. / Li, Li; Behrens, Ashley; Sweet, Paula M.; Osann, Kathryn E.; Chuck, Roy S.

In: Journal of Cataract and Refractive Surgery, Vol. 28, No. 5, 2002, p. 860-865.

Research output: Contribution to journalArticle

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AU - Osann, Kathryn E.

AU - Chuck, Roy S.

PY - 2002

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N2 - Purpose: To evaluate the safety and accuracy of a manual microkeratome and an artificial anterior chamber used at high intrachamber pressure to harvest corneal lenticules for lamellar keratoplasty. Setting: Department of Ophthalmology, University of California, Irvine, California, USA. Methods Forty-seven human eye-bank corneoscleral rims were mounted on an artificial anterior chamber. A manual microkeratome was used to perform lamellar keratectomy at a mean intrachamber pressure of 95.8 mm Hg ± 4.8 (SD). Two thicknesses (300 μm and 360 μm microkeratome heads) and diameters (8.0 mm and 9.0 mm) were attempted, and the resultant lenticules were analyzed by pachymetry and digital photography. Results: In the 9.0 mm/360 μm group, corneal perforation occurred in 12 of 17 lenticules (71.2%). Except for this group, 24 of 30 corneas (80.0%) showed a less than 0.5 mm deviation from the expected diameter. Neither the horizontal nor the vertical diameter differences were statistically significant (P > .05). The difference between the horizontal and vertical diameters was within ± 0.2 mm in 23 corneas (76.7%). Three (10.0%) corneal beds contained a slightly uneven keratectomy margin. Conclusions: This system provided accurate and smooth lenticules for lamellar keratoplasty. The precision and accuracy of the obtained corneal lenticules were better than those in previous reports. However, the 9.0 mm diameter/360 μm thickness head with high intrachamber pressure should not be applied in the clinical setting without further testing. In this laboratory study, a minimal corneal thickness of 588 μm was required to avoid perforation.

AB - Purpose: To evaluate the safety and accuracy of a manual microkeratome and an artificial anterior chamber used at high intrachamber pressure to harvest corneal lenticules for lamellar keratoplasty. Setting: Department of Ophthalmology, University of California, Irvine, California, USA. Methods Forty-seven human eye-bank corneoscleral rims were mounted on an artificial anterior chamber. A manual microkeratome was used to perform lamellar keratectomy at a mean intrachamber pressure of 95.8 mm Hg ± 4.8 (SD). Two thicknesses (300 μm and 360 μm microkeratome heads) and diameters (8.0 mm and 9.0 mm) were attempted, and the resultant lenticules were analyzed by pachymetry and digital photography. Results: In the 9.0 mm/360 μm group, corneal perforation occurred in 12 of 17 lenticules (71.2%). Except for this group, 24 of 30 corneas (80.0%) showed a less than 0.5 mm deviation from the expected diameter. Neither the horizontal nor the vertical diameter differences were statistically significant (P > .05). The difference between the horizontal and vertical diameters was within ± 0.2 mm in 23 corneas (76.7%). Three (10.0%) corneal beds contained a slightly uneven keratectomy margin. Conclusions: This system provided accurate and smooth lenticules for lamellar keratoplasty. The precision and accuracy of the obtained corneal lenticules were better than those in previous reports. However, the 9.0 mm diameter/360 μm thickness head with high intrachamber pressure should not be applied in the clinical setting without further testing. In this laboratory study, a minimal corneal thickness of 588 μm was required to avoid perforation.

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