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First Author: T.Senoo JAPAN
Co Author(s): N. Gotho K. Nakamura S. Ishimaru
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To review outcomes of FSL-assisted DSAEK and DALK using a single donor cornea.
Dokkyo Medical University School of Medicine
We performed DSAEK and DALK using a single donor cornea, each procedure given to 8 eyes of 4 patients (age, mean 73.9ḟ5.6 years): the causative disease was bullous keratopathy after laser peripheral iridectomy (n=3) and postcataract surgery (n=1) in DSAEK cases, and corneal leucoma (n=2), chemical burn (n=1) and corneal ulcer (n=1) in DALK cases. With the FSL (iFS) procedure donor a single cornea from a Japanese eye-bank produced 400-ṁm lamellar depth grafts with 8-mm and 7.5-mm in diameter for DSAEK and DALK, respectively. DSAEK was performed as the initial surgery in 4 cases, and DALK as the initial surgery in 3 cases and repeat surgery in 1 case.
Postoperative corneas were kept clear in all cases. After DSAEK, the best-corrected visual acuities measured 0.4, 1.2, 1.2 and 1.2, with improvements in each case. Surgeries and postoperative courses were uneventful with no graft damage or rejection, but adhesion of the graft with iris. After DALK, the best-corrected visual acuities were 0.02, 0.07, 0.08, and 0.5, with no change in one case and improvement in 3 cases. The host-donor junction was smooth with a small gap between the graft and host.
Use of FSL may create potentially an arbitrary graft component of high precision and enable to perform endothelial transplantation and deep lamellar stromal transplantation from a single donor cornea.