Table of Contents

Table of Contents


A Call to Action: Launching the International Journal of Eye Banking

Global Perspectives

The Evolution of Eye Banking in the United States: Landmarks in the History of the Eye Bank Association of America

European Eye Bank Association: Past, Present, and Future

Literature Review

Eye Banking in the 21st Century: How Far Have We Come? Are We Prepared for What’s Ahead?

Original Research

A Prospective, Randomized Trial of DSAEK Outcomes Comparing Different Donor Preparation Devices

Temporal Variability in the Number of Medically Eligible Corneas Released for Glycerol Preservation: the Global Sight Network Experience

Screening Potential Cornea Donors with Signs Indicating Possible Sepsis

Picture Challenge

Picture Challenge: What is This?

A Prospective, Randomized Trial of DSAEK Outcomes Comparing Different Donor Preparation Devices


W. Barry Lee, MD, Bryan E. Lusk, MD, Michael J. Lynn, MS


endothelial keratoplasty, DSAEK, microkeratome, precut tissue


PURPOSE: To determine whether Descemet stripping automated endothelial keratoplasty (DSAEK) outcomes differ between precut or surgeon-cut donor tissue and the Horizon or Moria systems.

DESIGN: This study was a randomized, prospective, double-masked clinical trial.

METHODS: Sixty-three consecutive DSAEK surgeries underwent tissue randomization. Thirty-three eyes underwent DSAEK using precut donor tissue prepared with the Horizon system (Group 1) and 30 eyes underwent DSAEK using tissue prepared by the surgeon with the Moria system (Group 2). Main outcome measures included visual acuity, mean endothelial cell loss, graft clarity, and complication rates.

RESULTS: The mean patient age was 70 +/- 10 (range, 55-87), with 52 eyes (83%) having Fuchs endothelial corneal dystrophy and 11 eyes (17%) with pseudophakic bullous keratopathy. Mean preoperative best spectacle-corrected visual acuity (BSCVA) was 20/96 (0.68) in Group 1 and 20/130 (0.81) in Group 2 (p value =0.19), and the mean postoperative BSCVA was 20/39 (0.29) in Group 1 and 20/47 (0.37) in Group 2 (p value = 0.25). Mean endothelial cell loss at 12 months was 30.9% in Group 1 and 28.2% in Group 2 (p value = 0.28). Mean induced astigmatism at 6 months was -0.01D in Group 1 and 0.17D in Group 2 (P = 0.59). Group 1 had 3 (9.1%) tissue dislocations and Group 2 had 2 (6.5%) tissue dislocations (P = 0.1). Group 1 had 1 (3.0%) primary graft failure (PGF) and Group 2 had none (P = 0.1). Endothelial graft rejection and pupil block glaucoma were not observed.

CONCLUSIONS: No statistical difference was observed in DSAEK outcomes regardless of whether the tissue was precut or surgeon-cut or whether prepared by the Horizon or Moria devices.


Price FW Jr., Price MO. Descemet stripping with endothelial keratoplasty in 200 eyes: early challenges and techniques to enhance donor adherence. J Cat Refract Surg. 2006;32(3):411-8.

Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea. 2006;25(8):886-9.

Covert DJ, Koenig SB. New triple procedure: Descemet stripping and automated endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation. Ophthalmology. 2007;114(7):1272-7.

Terry MA, Shamie N, Chen ES, et al. Endothelial keratoplasty: the influence of preoperative donor endothelial cell densities on dislocation, primary graft failure, and 1-year cell counts. Cornea. 2008;27(10):1131-7.

Chen ES, Terry MA, Shamie N, et al. Descemet-stripping automated endothelial keratoplasty: six month results in a prospective study of 100 eyes. Cornea. 2008;27(5):514-20.

Terry MA, Chen ES, Shamie N, et al. Endothelial cell loss after Descemet stripping endothelial keratoplasty in a large prospective series. Ophthalmology. 2008;115(3):488-96.

Terry MA. Endothelial keratoplasty: a comparison of complication rates and endothelial survival between precut tissue and surgeon-cut tissue by a single DSAEK surgeon. Trans Am Ophthalmol Soc. 2009;107:184-93.

Price MO, Fairchild KM, Price DA, et al. Descemet stripping endothelial keratoplasty: 5-year graft survival and endothelial cell loss. Ophthalmology. 2011;118(4):725-9.

Lee WB, Jacobs DS, Musch DC, et al. Descemet stripping endothelial keratoplasty: safety and outcomes: a report by the American Academy of Ophthalmology. Ophthalmology. 2009;116(9):1818-30.

Price MO, Baig KM, Brubaker, et al. Randomized, prospective comparison of precut vs surgeon-dissected grafts for descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2008;146(1):36-41.

Chen ES, Terry MA, Shamie N, et al. Precut tissue in Descemet stripping automated endothelial keratoplasty donor characteristics and early postoperative complications. Ophthalmology. 2008;115(3):497-502.

Kitzmann AS, Goins KM, Reed C, et al. Eye bank survey of surgeons using precut donor tissue for descemet stripping automated endothelial keratoplasty. Cornea. 2008;27(6):634-9.

Jones YJ, Goins KM, Sutphin JE, et al. Comparison of the femtosecond laser (IntraLase) versus manual microkeratome (Moria ALTK) in dissection of the donor in endothelial keratoplasty: initial study in eye bank eyes. Cornea. 2008;27(1):88-93.

Rauen MP, Goins KM, Sutphin JE, et al. Impact of eye bank lamellar tissue for endothelial keratoplasty on bacterial and fungal corneoscleral donor rim cultures after corneal transplantation. Cornea. 2012;31(4):376-9.


Article PDF

Fullscreen Mode