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Session Title: Cornea surgical I
Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30
Paper Time: 08:00
Venue: Forum (Ground Floor)
First Author: : R.Nuijts THE NETHERLANDS
Co Author(s): : P. Steijger Vermaat Y. Schuchard F. van Marion F. van den Biggelaar T. Berendschot M.
To determine the endothelial cell loss associated with precutting of ultrathin endothelial grafts for endothelial keratoplasty using an innovative microkeratome technology.
Euro Cornea Bank, Beverwijk, The Netherlands, Maastricht University Medical Center, Maastricht The Netherlands.
Twenty-two paired donor corneas (n=44) unsuitable for transplantation because of anterior stromal pathology or senile arcus with otherwise normal endothelium were organ cultured under standard conditions. All corneas were transferred to an organ culture medium supplemented with 6% Dextran for deswelling 24 hours prior to dissection. Posterior lamellar buttons were harvested from one cornea of each pair (n=22) using a Gebauer microkeratome (SLc; Gebauer Medizintechnik) equipped with either a 400, 450, 500 or a 550 µm head aiming at a residual thickness < 100 µm. The endothelium was inspected by light microscopy after trypan blue staining upon arrival at the cornea bank, following deswelling and 1 hour and 3 days following dissection. Linear Mixed Model (LMM) analysis was performed to quantify the differences in ECD between cut and uncut corneas.
Mean donor age was 72 ± 8 years. Mean death to explantation and explantation to preservation time was 12 ± 6 hours and 12 ± 8 hours, respectively. Upon arrival at the cornea bank there was no significant difference in ECD between cut and paired uncut corneas (2641±258 cells/mm2, p>0.05). Incubation (23 ± 9 days) was associated with a significant ECD loss of 5% (113 cells/mm2, p=0.001) representing an average decrease of 8.51 cells/mm2 per storage day. Single pass ultrathin endothelial graft preparation was not associated with a significant ECD loss (0.5%, p>0.05).
Single pass ultrathin (<100 µm) dissection of endothelial grafts using an innovative microkeratome technology is not associated with significant ECD loss. Incubation time was the sole predictive factor for ECD loss during organ culture storage. Further randomized trials are needed to determine the clinical results of ultrathin endothelial keratoplasty grafts prepared using this innovative technology.
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