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Precut 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 Gisoldi4,
  5. Carlo Maria Villani4,
  6. Augusto Pocobelli4
  1. 1 Eye Bank of Rome, S.Giovanni-Addolorata-Britannico, Rome, Italy;
  2. 2 G.B.Bietti Eye Foundation IRCCS, Rome, Italy;
  3. 3 Department of Medicine and Ageing Science, Ophthalmology Clinic, University of Chieti-Pescara, Italy;
  4. 4 S.Giovanni-Addolorata-Britannico Hospital, Rome, Italy
  1. Correspondence to: Domenico Amato, Eye Bank, S.Giovanni-Addolorata-Britannico Hospital, Via S.Giovanni in Laterano n.155, Rome, 00184, Italy; damato{at}


Background/Aims: To compare two different techniques for preparation of precut lamellar corneal tissue for Descemet Stripping Automated Keratoplasty (DSAEK).

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 ). While the 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, 4 and 24 hours after dissection.

Results: Average pre-cut eendothelial cell density was 2552,25 ( ± 105 ) and 2572,25 ( ± 110 ) cells/mm2 in AL-off and AL-on group respectively ( p= 0,7 ). At 24h cell density was 2404,87 ( ± 74 ) in AL-off ( p< 0,01 ) and 2368,74 ( ± 148) in 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 approximately 20% in both groups after 24h cold storage.

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

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