Ultra-thin DSAEK grafts prepared with a single cut technique using Moria Evolution 3 microkeratome system

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 08:31

Venue: Boulevard B

First Author: : E.Abdullayev USA

Co Author(s): :    D. Moore              

Abstract Details

Purpose:

To present an experience in preparation of the Ultra-Thin grafts with thickness 50-100 microns for endothelial keratoplasty with our new single cut technique by using MORIA Evolution3 Microkeratome system

Setting:

International Sight Restoration Inc.

Methods:

A retrospective analysis of consecutive ultra-thin grafts prepared at one eye bank with a new single cut microkeratome method was performed. 260 donor corneas preserved in cold storage media and suitable for transplant were used along with standard MORIA Evolution 3 microkeratome system and heads 110, 250,300,350 microns were utilized. To create Ultra-Thin DSAEK grafts with a single microkeratome cut, the pressure in the artificial anterior chamber was increased prior to cut more than 90 Hg mm for several minutes. The central corneal thickness (CCT) prior to cuts and central graft thickness (CGT) post cuts were measured by contact pachymeter with ultra-thin mode. Corneas were evaluated by the eye-bank slit lamp, new back light and specular bio-microscopies before and after graft preparation. Optical Coherence Tomography (OCT) was used as a quality control measure. Absence of perforation, acceptable specular evaluation and residual bed thickness between 50 and 100 microns were determined as success.

Results:

260 ultra-thin donor grafts for endothelial keratoplasty were prepared with a single cut microkeratome technique. No perforations (0%), no endothelial damage, no cap dislocations nor other complications occurred. Endothelial cell density before cut - 3086 ± 37 cell/mm²., after cut - 3049±41 cell/mm²; CCT before cut-490 microns and CGT after cut – 81 microns. Thinnest graft was 52 microns and thickest 100 microns with an average cap diameter of 9.5mm. 259 (99.6%) of the ultra-thin grafts were transplanted in the USA and other 12 foreign countries. Only 1 primary graft failure, 5 interface hazes, 3 technical difficulties during insertion was reported.

Conclusions:

The ultra-thin donor grafts for endothelial keratoplasty can be safely prepared with a new single cut technique in the eye bank with no increased risk of perforations and no endothelial cell loss. Use of the MORIA Evolution 3 Microkeratome system eliminates the need for a procedure-fee increase. The prepared ultra-thin grafts survive a long distance with international shipping.

Financial Interest:

NONE