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Development of a moria microkeratome nomogram for DSAEK

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First Author: Á.Sánchez-Ventosa SPAIN

Co Author(s):    A. Cano-Ortiz   V. Diaz   A. Villarrubia Cuadrado              

Abstract Details

Purpose:

To create a nomogram that includes the translational speed of the microkeratome blade, microkeratome head size and the precut tissue thickness in order to predict the postcut thickness for Descemet stripping automated endothelial keratoplasty (DSAEK) and thus obtain the thinnest possible graft.

Setting:

Hospital la Arruzafa, Córdoba, Spain

Methods:

Grafts for DSAEK were prepared using Moria Evolution 3E(Moria SA)microkeratome. Target donor lamella thickness was between 70-120μm and the microkeratome head size was selected 150μm lower than the thickness of the donor cornea. Under the principle the slower the translational speed of the microkeratome blade, the thicker the anterior lamella produced, the donor cut was performed at different speeds,being ‘speed1’ 10% slower than ‘speed2’.With thicknesses of 650,600,550 and 500,we used a blade head of 500,450,400 and 350 respectively, using speed2; with thicknesses of 625,575 and 525 we used a head of 450,400 and 350μm respectively,at speed1

Results:

A total of 55 donor grafts were prepared during the study period. The mean graft thickness was 102.93 ± 38.96 µm (range: 39-209 µm). From the 55 samples, 17 were below 80µm (30.91%), 25 between 81 and 120µm (45.45%) and 13 were above 120µm (23.64%). Of note, 72% (42/55) of grafts were below 120 µm

Conclusions:

The use of a proper nomogram with an automated microkeratome to obtain a thin graft for DSAEK provided good results in terms of graft thickness. However, in almost a quarter of the cases a graft greater than 120um was obtained. This nomogram will help us to further adjust the cut so that 95% of the thicknesses are below 120µm and 75% below 80µm.

Financial Disclosure:

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