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Pre-cut donor tissue for Descemet stripping automated keratoplasty: anterior hinged lamella on versus off
  1. Domenico Amato1,
  2. Francesco Oddone2,
  3. Mario Nubile3,
  4. Rossella Anna Maria Colabelli Gisoldi1,
  5. Carlo Maria Villani1,
  6. Augusto Pocobelli1
  1. 1S.Giovanni-Addolorata-Britannico Hospital, Rome, Italy
  2. 2G.B.Bietti Eye Foundation IRCCS, Rome, Italy
  3. 3Department of Medicine and Ageing Science, Ophthalmology Clinic, University of Chieti, Italy
  1. Correspondence to Dr Domenico Amato, Via Merulana, 143, 00184 Rome, Italy; damato{at}


Aims To compare two different techniques for preparation of pre-cut lamellar corneal tissue for Descemet stripping automated keratoplasty.

Background/Methods Eight donor lenticules were created with a full pass of the microkeratome blade, which resulted in a posterior lamella and a free cap (anterior lamella off group (AL-off)). Contralateral donor lenticules were created with an incomplete pass of the microkeratome blade, which resulted in a posterior lamella and a hinged anterior cap (anterior lamella on group (AL-on)). Endothelial cell density, cellular viability and corneal thickness were evaluated before dissection, and 4 and 24 h after dissection.

Results Average pre-cut endothelial cell density was 2552.25 (±105) and 2572.25 (±110) cells/mm2 in the AL-off group and AL-on group, respectively (p=0.7). At 24 h cell density was 2404.87 (±74) in the AL-off group (p<0.01) and 2368.74 (±148) in the AL-on group (p=0.01). The mean percentage of trypan blue-stained cells was consistently higher in the hinged AL-on group. Corneal thickness increased by approximately 20% in both groups after 24 h cold storage.

Conclusion Eye bank-prepared tissue offers the potential advantage of being screened for mechanical stress damage occurring during the automated dissection.

  • eye banking, pre-cut tissue

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  • Competing interests None declared.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of S.Giovanni-Addolorata-Britannico Hospital. All the research and measurements adhered to the tenets of the Declaration of Helsinki

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.