TY - JOUR
T1 - Ultra-thin donor tissue preparation for endothelial keratoplasty with a double-pass microkeratome
AU - Sikder, Shameema
AU - Nordgren, Rick N.
AU - Neravetla, Shantanu R.
AU - Moshirfar, Majid
N1 - Funding Information:
Publication of this article was Supported by Research to Prevent Blindness, Inc, New York, New York, to the University of Utah. The authors indicate no financial conflict of interest. Involved in Design of study (S.S., M.M.); Conduct of study (S.S., R.N.N., M.M., S.R.N.); Collection (S.S., R.N.N., M.M., S.R.N.), management (S.S., R.N.N., S.R.N., M.M.), and analysis and interpretation (S.S., R.N.N., S.R.N., M.M.) of data; and preparation (S.S., R.N.N., S.R.N., M.M.) and review or approval (S.S., R.N.N., S.R.N., M.M.) of the manuscript. The authors thank Ladan Espandar for her statistical consultation and review.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2011/8
Y1 - 2011/8
N2 - Purpose: To quantify and describe practically a novel technique for donor tissue preparation in Descemet stripping endothelial keratoplasty to approach the superior visual outcomes of Descemet membrane endothelial keratoplasty. Design: Experimental laboratory investigation. Methods: setting: Institutional. study population: Eleven human donor corneas. intervention: Double-pass of microkeratome over donor corneasfirst with a thicker cutting depth and subsequently with a thinner cutting depth. Main Outcome Measures: Donor tissue profiles and residual bed thicknesses. Results: After the first pass of the microkeratome, the average cut thickness using the 250-μm cutting head was 342.5 ± 14.8 μm (range, 332 to 353 μm), that using the 300-μm head was 343.8 ± 39.2 μm (range, 315 to 411 μm), and that with the 350-μm head was 467.7 ± 50.1 μm (range, 419 to 519 μm). We used the 200-μm cutting head only once with a cut depth of 210 μm. For the second pass, when using the 110-μm head, the cutting depth averaged to 167.8 ± 28.8 μm (range, 133 to 203 μm). The 130-μm cutting head yielded a cut depth of 199.7 ± 24.4 μm (range, 180 to 227μm). Two corneas were perforated during the second pass. The average final thickness of the residual bed was 121 ± 32.2 μm (range, 52 to 160 μm). Conclusions: Double-pass harvest for ultra-thin Descemet stripping automated endothelial keratoplasty could improve optical outcomes by obtaining donor Descemet stripping automated endothelial keratoplasty tissue with thinner residual beds. Further studies are needed with larger sample sizes to establish algorithms for appropriate cutting head thickness in each pass. Potential additional endothelial cell loss with the second pass of the microkeratome also should be evaluated.
AB - Purpose: To quantify and describe practically a novel technique for donor tissue preparation in Descemet stripping endothelial keratoplasty to approach the superior visual outcomes of Descemet membrane endothelial keratoplasty. Design: Experimental laboratory investigation. Methods: setting: Institutional. study population: Eleven human donor corneas. intervention: Double-pass of microkeratome over donor corneasfirst with a thicker cutting depth and subsequently with a thinner cutting depth. Main Outcome Measures: Donor tissue profiles and residual bed thicknesses. Results: After the first pass of the microkeratome, the average cut thickness using the 250-μm cutting head was 342.5 ± 14.8 μm (range, 332 to 353 μm), that using the 300-μm head was 343.8 ± 39.2 μm (range, 315 to 411 μm), and that with the 350-μm head was 467.7 ± 50.1 μm (range, 419 to 519 μm). We used the 200-μm cutting head only once with a cut depth of 210 μm. For the second pass, when using the 110-μm head, the cutting depth averaged to 167.8 ± 28.8 μm (range, 133 to 203 μm). The 130-μm cutting head yielded a cut depth of 199.7 ± 24.4 μm (range, 180 to 227μm). Two corneas were perforated during the second pass. The average final thickness of the residual bed was 121 ± 32.2 μm (range, 52 to 160 μm). Conclusions: Double-pass harvest for ultra-thin Descemet stripping automated endothelial keratoplasty could improve optical outcomes by obtaining donor Descemet stripping automated endothelial keratoplasty tissue with thinner residual beds. Further studies are needed with larger sample sizes to establish algorithms for appropriate cutting head thickness in each pass. Potential additional endothelial cell loss with the second pass of the microkeratome also should be evaluated.
UR - http://www.scopus.com/inward/record.url?scp=79960840275&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960840275&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2011.01.051
DO - 10.1016/j.ajo.2011.01.051
M3 - Article
C2 - 21664596
AN - SCOPUS:79960840275
SN - 0002-9394
VL - 152
SP - 202-208.e2
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 2
ER -