First experience and clinical results of DSAEK utilizing the pre-cut ultrathin grafts

Abstract

ABSTRACT Purpose. To evaluate the clinical functional efficiency of pre-cut donor corneas stored in the original preservation medium for the Ultrathin DSAEK procedure. Material and methods. UT-DSAEK procedure was performed in 10 patients with corneal endothelial dystrophy using 10 donor corneas stored in the Borzenok-Moroz medium for 15 hours after pre-cut lamellar dissections performed with the microkeratome. Finally intra-operatively the donor cornea disc was formed from 7.0 to 8.5 mm in diameter depending on the anterior segment individual characteristics of the recipient eye. A minimal initial endothelial cell density (ECD) of the transplant was 2500 (cells/mm2). Results. The average index of a central donor cornea thickness after lamellar dissection (pre-cut stage) was 98.2±6.91µm. The central donor cornea thickness measured intra-operatively after the extraction from the storage medium was 122.0±9.21µm. After the surgery no dislocation or donor graft detachment was observed. Endothelial cell density loss was 29% at 6 months. Best corrected visual acuity in patients without retinal pathology was 0.8±0.1. Conclusion. Medium storage preservation causes swelling of lamellar corneal-scleral disc and increasing its average thickness by 24%. Advanced stromal hydration of corneal tissue does not increase a risk of donor graft dislocation or detachment in the early postoperative follow-up and does not effect on the dynamics. This confirmed the safety and efficiency of the proposed method.

Keywords

• Ultrathin DSAEK
• pre-cut cornea button
• eye banking
• corneal endothelium.