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Automated harvesting of pre-descemetic automated endothelial keratoplasty (PDAEK) grafts using innovative microkeratome technology

Session Details

Session Title: Cornea

Session Date/Time: Sunday 16/02/2014 | 08:30-11:00

Paper Time: 09:24

Venue: Linhart Hall (Level -2)

First Author: : MorDickman THE NETHERLANDS

Co Author(s): :    Friso W.F. Van Marion   Teja Wesseling   Petra Steijger-Vermaat   Tos T.J.M. Berendschot   Rudy M.M.A. Nuijts  

Abstract Details

Purpose:

This study set out to examine the feasability of automatic harvesting of planar pre-Descemetic endothelial grafts (<50 microns) using a novel mechanical microkeratome system (Gebauer SLc Expert).

Setting:

University Eye Clinic Maastricht, Maastricht, The Netherlands Euro Cornea Bank, Beverwijk, The Netherlands

Methods:

Twenty-one organ cultured human corneas unsuitable for transplantation were mechanically harvested with and without correction for central to peripheral thickness differences using a set of curved rigid reference members (RRM). Central and peripheral corneal thickness measurements were obtained using Fourier domain Anterior Segment Optical Coherence Tomopgraphy (Casia SS-1000; Tomey) and endothelial cell density (ECD) was determined by standard trypan blue exclusion.Pancorneal endothelial viability of 5 donor grafts was determined using triple Hoechst Ethidium Calcein (HEC) labeling.

Results:

Mean attempted and achieved post-cut central graft thickness measured 32 (±6) microns and 44 (±7.7) microns, respectively. Compensation for central to peripheral thickness differences using a set of curved RRM's resulted in a significantly more planar graft thickness profile, compared with the meniscus shape achieved without such correction. Mean post-cut endothelial cell density measured 2245 cells/mm2 with an average 70% pancorneal endothelial viability.

Conclusions:

This study established a proof of concept for highly accurate automated harvesting of planar pre-Descemetic endothelial grafts with satisfactory endothelial cell density, morphology and viability, addressing many of the limitations of current mechanical harvesting techniques. FINANCIAL INTEREST: ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented