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Comparison of donor tissue preparation methods for Descemet's stripping automated endothelial keratoplasty

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Session Details

Session Title: Presented Poster Session: Cornea I

Venue: Poster Village: Pod 3

First Author: : S.Nishisako JAPAN

Co Author(s): :    D. Aoki   C. Sasaki   K. Higa   J. Shimazaki     

Abstract Details

Purpose:

Donor tissue preparation with high reproducibility in its thickness and minimal tissue damage is essential for success in Descemet-stripping automated endothelial keratoplasty (DSAEK). To optimize the human donor corneal lenticule quality after dissection, five experimental conditions with different internal pressures and cutting systems were examined.

Setting:

Cornea Center & Eye Bank, Tokyo Dental College Ichikawa General Hospital, Chiba, JAPAN

Methods:

Thirty human research corneas were divided into five groups (six eyes each). The artificial anterior chamber internal pressure (IP) was set at 100 or 200 mmHg. The IP change during dissection was measured by real-time pressure sensor (nVision Reference Recorder, AMETEK). Microkeratome cut was performed with or without Moria Artificial Chamber Pressurizer (ACP), and using Moria CB microkeratome or One Use-Plus Automated (OUP-A), with 350 μm head. Cut depth and uniformity of the graft thickness was measured using anterior segment OCT (CASIA SS-1000, TOMEY). Endothelial cell density (ECD) and live/dead assay were also studied.

Results:

Variation of the mean anterior cap thickness and the mean residual donor tissue thickness at center and 4 points in periphery after dissection were found to be smaller in IP 200 than IP100 mmHg groups (436.9 μm [range from 330.8 to 554.3 μm] vs 365.8 μm [62.6 to 537.9 μm]) (57.9 μm [6.4 to 135.7 μm] vs 129.8 μm [35.9 to 254.6μm]). The smallest CV of the anterior cap thickness were obtained with the IP 200 mmHg using ACP and OUP-A. There were no statistically significant differences among the groups in either ECD or live/dead assay after the cut.

Conclusions:

The results suggested that the graft preparation with the IP of 200 mmHg using ACP and OUP-A has the highest reproducibility of the cut depth and the best uniformity of the graft thickness for DSAEK graft. ACP is useful in setting the IP accurately at 200 mmHg during the graft cut. OUP-A is beneficial for anyone in making the stable operation of graft cutting.

Financial Disclosure:

receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented., travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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