April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Interfaces of femto-assisted endothelial keratoplasty
Author Affiliations & Notes
  • Jean-Louis Bourges
    Ophthalmology, Sorbonne Paris Cité University, Paris Descartes School of medicine, Paris, France
    Ophthalmology, Pole Hotel-Dieu Cochin, site Hotel-Dieu, Assistance Publique-Hopitaux de Paris, Paris, France
  • Michele Savoldelli
    Ophthalmology, Sorbonne Paris Cité University, Paris Descartes School of medicine, Paris, France
    Team 17, INSERM UMRS 872, CIC des Cordeliers, Paris, France
  • Francine F Behar-Cohen
    Team 17, INSERM UMRS 872, CIC des Cordeliers, Paris, France
  • Footnotes
    Commercial Relationships Jean-Louis Bourges, None; Michele Savoldelli, None; Francine Behar-Cohen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4722. doi:
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    • Get Citation

      Jean-Louis Bourges, Michele Savoldelli, Francine F Behar-Cohen; Interfaces of femto-assisted endothelial keratoplasty. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4722.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: to analyze the area of altered collagen layer at graft’s interface of femto-assisted endothelial keratoplasty (FLEK)

Methods: We collected corneas from patients who underwent penetrating keratoplasty after failed FLEK and observed graft’s interface by transmission electron microscope (TEM). Ten pictures were captured from TEM observation fields within the 3 mm central area for each cornea. Collagen fibers and fibrillae were observed. The interface area were isolated and the thickness of damaged collagen was semi-quantified within 5 groups ( G1<1µm, G2=1 to 5 µm, G3>5 to 10µm, G4>10µm to 15µm and G5>15 µm).

Results: Four corneas were analyzed (4 patients, 2 post-rejection failures, 1 secondary endothelial failure, 1 poor visual recovery). The average (±SD) interface length studied was 96.9±12µm. At the graft’s interface, disrupted collagen fibrillae were systematically observed whereas recipients displayed normal arrangement of lamellae. The average lengths of the disrupted collagen layer on TEM fields were G1=4.1±11.9 (4%); G2=34±39.2 (33%); G3=26.8±31.1 (26%); G4=23.6±30.8 (26%); G5=8.5 20.3 (10%). An irregular arrangement of collagen lamellae was observed in 3/4 corneas.

Conclusions: A collagen lamellae rearrangement and significant collagen fibrillae disruption is observed after FLEK on the graft’s side of the interface. It could likely participate in the poor visual outcomes reported after femto-assisted DSEK.

Keywords: 479 cornea: clinical science • 484 cornea: stroma and keratocytes • 484 cornea: stroma and keratocytes  
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