Subscribe

Table of Contents

Table of Contents

Editorial

Letter from the Editor

Featured Article

Reflections on the Success and Future of Eye Banking

Proceedings

Reflections on the Success and Future of Eye Banking

The Alphabet Soup of Superbugs

Increasing Eye Donations with an Effective Marketing Program

Assessing Environmental Contamination During Corneal Processing

Microkeratome Cut Time as a Variable in Endothelial Keratoplasty Graft Thickness

Eye Health in Pakistan: Implications for Eye-Bankers

Microkeratome Cut Time as a Variable in Endothelial Keratoplasty Graft Thickness

Authors

Stephen C Kaufman, MD, PhD; Natalia Kramarevsky, MD; Alessandro Meduri, MD

Keywords

Descemet-stripping automated endothelial keratoplasty (DSAEK), endothelial keratoplasty, microkeratome cut time, pachymetry

Abstract

ABSTRACT

Purpose: To evaluate the effect of the time used to pass the
microkeratome through the cornea during the production of
a DSAEK graft on the thickness of the posterior lamellar corneal
graft.

Methods: Twelve human corneoscleral discs were used to evaluate
the effect of microkeratome (Moria CB, Antony, France) cut
time on post-sectioned corneal lamellar thicknesses. Sectioning
was completed using a microkeratome equipped with three
microkeratome head sizes (250, 300, and 350 μm) utilizing two
different cut times (1 or 6 seconds). Eye bank excised corneas
with scleral rims were mounted on a Moria artificial anterior
chamber and the intrachamber pressure was increased to >90
mmHg. The Moria DSAEK microkeratome was used to prepare
the posterior lamellar graft tissue. Pachymetry was performed
before and after construction of the graft tissue.

Results: All corneas sectioned over a 1 second period produced
thicker residual stromal beds compared with 6 second sectioning
times. The difference between the mean residual stromal bed
thickness for all head sizes was 37 ± 50 μm thicker than intended
for 1 second cuts and 41 ± 32 μm thinner than intended for
6 second cuts (P = 0.01). The longer pass always resulted in a
thicker corneal flap. The mean total difference in corneal flap
thickness between a 1 second cut time and a 6 second cut time
for all 3 microkeratome head (250, 300 and 350 μm) sizes was
77.7 μm.

Conclusions: This pilot study provides proof of principle that
microkeratome cut time (transit time) is an important variable,
which affects graft thickness, in endothelial keratoplasty graft
preparation.

Article PDF

Fullscreen Mode