Posters

UT-DSAEK performed with an excimer laser (E-DSAEK): experimental study and preliminary clinical outcomes

Poster Details

First Author: A.Pashtaev RUSSIA

Co Author(s):    B. Malyugin   S. Izmailova   S. Alieva   K. Kuzmichev   K. Tonaeva        

Abstract Details

Purpose:

To evaluate the quality of the surface of UT transplant ablated by excimer laser, to evaluate endothelial cell death in vivo and to demonstrate preliminary clinical outcomes of UT-DSАEK performed with a cut of mechanical microkeratome with subsequent excimer laser ablation (E-DSAEK).

Setting:

S. Fyodorov Eye Microsurgery Complex Federal State Institution, Moscow, Russia.

Methods:

A technique of ultra-thin endothelial donor corneal graft preparation with a cut of microkeratome with subsequent excimer laser ablation (“Microscan”, Russia) was developed. Roughness of laser graft surface was measured by atomic force microscopy comparative to the one, created by microkeratome (Moria III). EC loss after laser ablation in vitro was evaluated by live/dead cell essay (Calceine AM/ Propidium Iodide) comparatively to UT-DSAEK graft harvested from the same donor. E-DSAEK procedures were performed for 10 patients with endothelial dystrophy. Observation period amounted 1 year. BSCVA, postoperative astigmatism, EC density, EC loss, central graft thickness and transplant-recipient complex thickness were evaluated.

Results:

Atomic force microscopy showed roughness mean square (RMS) of laser cut equal to 16.15±3.9 um, comparable to RMS of microkeratome-assisted cut of 22.3±18.3 um (p=0.19). EC loss in vitro was 9±3.8% for E-DSAEK grafts and 8.1±2% for UT-DSAEK grafts (p=0.22). At 1-year follow-up all transplants were clear. BSCVA varied from 0.4 to 0.8. Mean postoperative astigmatism was 0,9±0,26 D. EC density amounted 1566±150 cells/mm2. EC loss - 43%. Central graft thickness was 74±18 um and transplant-recipient complex thickness was 543±17 um.

Conclusions:

A technique of ultra-thin donor corneal tissue preparation with a cut of mechanical microkeratome with subsequent excimer laser ablation allowed to produce transplants with smooth surface safe for donor endothelium and to achieve quite high clinical outcomes with E-DSAEK.

Financial Disclosure:

None