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Pre-cut donor tissue for Descemet stripping automated keratoplasty: anterior hinged lamella on versus off

Abstract

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.

  • DSAEK
  • eye banking, pre-cut tissue

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