Yoav Nahum1, Pia Leon, Massimo Busin. 1. *Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Department of Ophthalmology, "Villa Igea" Hospital, Forlì, Italy; and §Istituto internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
Abstract
PURPOSE: To evaluate the results of microkeratome-assisted ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) using a nomogram developed for the single-pass technique. METHODS: A retrospective study of eyes operated between September 2014 and March 2015 at Villa Serena-Villa Igea Private Hospitals (Forlì, Italy) by a single surgeon (M.B.). Study eyes underwent UT-DSAEK performed using a linear microkeratome-assisted lamellar dissection with disposable heads of different sizes (Moria ALTK system; Moria SA) chosen according to a pachymetry-based nomogram developed at our department. The main outcome measure was the graft thickness as assessed by means of anterior segment optical coherence tomography, measured between 1 and 3 months postoperatively. RESULTS: Forty-two eyes were included in this study. Mean follow-up time was 5.0 ± 1.8 months (range 1.2-6.9 months). No perforation or other complication occurred during graft preparation. Mean postoperative central thickness of donor grafts was 63 ± 29 μm. Thickness ranged between 23 and 177 μm, and the second thickest graft measured 116 μm. By 3 months postoperatively, 41/42 (97%) of the grafts were of thickness ≤130 μm and 38/42 (90%) of the grafts were of central thickness ≤100 μm. The mean nasal-to-temporal absolute thickness difference at the graft's central 3-mm zone was 5 ± 7 μm at the last available measurement. CONCLUSIONS: The nomogram developed at our institution allowed reliable single-pass microkeratome-assisted dissection of donor tissue, creating consistently thin and symmetric grafts without loss of tissue. The results obtained compare favorably with those reported in the past for double-pass microkeratome-assisted dissection of UT-DSAEK.
PURPOSE: To evaluate the results of microkeratome-assisted ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) using a nomogram developed for the single-pass technique. METHODS: A retrospective study of eyes operated between September 2014 and March 2015 at Villa Serena-Villa Igea Private Hospitals (Forlì, Italy) by a single surgeon (M.B.). Study eyes underwent UT-DSAEK performed using a linear microkeratome-assisted lamellar dissection with disposable heads of different sizes (Moria ALTK system; Moria SA) chosen according to a pachymetry-based nomogram developed at our department. The main outcome measure was the graft thickness as assessed by means of anterior segment optical coherence tomography, measured between 1 and 3 months postoperatively. RESULTS: Forty-two eyes were included in this study. Mean follow-up time was 5.0 ± 1.8 months (range 1.2-6.9 months). No perforation or other complication occurred during graft preparation. Mean postoperative central thickness of donor grafts was 63 ± 29 μm. Thickness ranged between 23 and 177 μm, and the second thickest graft measured 116 μm. By 3 months postoperatively, 41/42 (97%) of the grafts were of thickness ≤130 μm and 38/42 (90%) of the grafts were of central thickness ≤100 μm. The mean nasal-to-temporal absolute thickness difference at the graft's central 3-mm zone was 5 ± 7 μm at the last available measurement. CONCLUSIONS: The nomogram developed at our institution allowed reliable single-pass microkeratome-assisted dissection of donor tissue, creating consistently thin and symmetric grafts without loss of tissue. The results obtained compare favorably with those reported in the past for double-pass microkeratome-assisted dissection of UT-DSAEK.
Authors: Kevin W Ross; Christopher G Stoeger; George O D Rosenwasser; Robert C OʼBrien; Loretta B Szczotka-Flynn; Allison R Ayala; Maureen G Maguire; Beth Ann Benetz; Patricia Dahl; Donna C Drury; Steven P Dunn; Sameera M Farazdaghi; Caroline K Hoover; Marian S Macsai; Shahzad I Mian; Michael L Nordlund; Jeffrey G Penta; Mark C Soper; Mark A Terry; David D Verdier; Doyce V Williams; Jonathan H Lass Journal: Cornea Date: 2019-09 Impact factor: 3.152