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Table of Contents

Table of Contents

Editorial

Letter from the Editor

Original Research

Tissue Processing Factors Influencing Descemet Stripping Automated Endothelial Keratoplasty Thickness and Endothelial Outcomes

Challenges in Testing Post-Mortem Blood Samples

Epithelial Desquamation, Regeneration and Renewal in Corneal Graft Prepared for Clinical Use

Corneal Cross-linking for the Treatment of Keratoconus: Laboratory Science, Clinical Effect and the Potential Impact to Eye Banking in the United States

Proceedings

Corneal Cross-linking for the Treatment of Keratoconus: Laboratory Science, Clinical Effect and the Potential Impact to Eye Banking in the United States

Report

Specular Microscopy Image Quality Scale for Endothelial Cell Density Determination in Donor Cornea Tissue

Tissue Processing Factors Influencing Descemet Stripping Automated Endothelial Keratoplasty Thickness and Endothelial Outcomes

Authors

Maria A. Woodward, N.D., M.S, Nita G. Valikodath, M.S., Bernardino Iliakis, MHA, CEBT

Abstract

ABSTRACT
Introduction: Descemet stripping automated endothelial
keratoplasty tissue thickness can be modified by various tissue
processing factors including microkeratome (MK) head size,
anterior chamber pressure (ACP), and cut pass duration.
Objective: Our primary objective was to evaluate how changes
in MK head size, ACP, and cut pass duration affect endothelial
cell counts and tissue thickness.

Methods: Donor corneas underwent tissue processing under various
combinations of MK head size, ACP, and cut pass duration.
Endothelial cell density (ECD) and optical coherence tomography
(OCT) were recorded both pre- and post-processing. We performed
multivariable linear regression to determine if MK head
size, ACP, and cut pass duration were associated with change in
ECD or tissue cut depth as measured by OCT.

Results: 38 corneas underwent processing. For every 50 μm
increase in MK head size, 77.32 ± 6.71 μm more anterior tissue
was cut (p < 0.0001). For every 5 mmHg increase in ACP,
15.19 ± 6.59 μm more anterior tissue was cut (p=0.03). Cut pass
duration was not associated with tissue cut depth (p=0.19). MK
head size, ACP, and cut pass duration were not associated with
changes in ECD (all p > 0.05).

Conclusions: Tissue processing parameters did not impact ECD.
MK head size and ACP did affect tissue cut depth and is likely
clinically significant.

Key Words: endothelial keratoplasty, eye bank, tissue preparation

Abbreviations: DSAEK, Descemet Stripping Automated Endothelial
Keratoplasty; MK, microkeratome; ACP, anterior chamber
pressure; ECD, endothelial cell density; OCT, optical coherence
tomography; TT, tissue thickness; DMEK, Descemet’s membrane
endothelial keratoplasty; BSS, balanced salt solution

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