June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Wound healing of posterior corneal lamellea after mechanical or femtolaser precut DSEAK
Author Affiliations & Notes
  • Jean-Louis Bourges
    UMRS 1138, Team 17, Centre de Recherche des Cordeliers, INSERM,, Paris, France
    Department of ophthalmology, Sorbonne Paris Cite university, Paris Descartes faculty of medicine, Hotel-Dieu Cochin Hospital, APHP, Paris, France
  • Michele Savoldelli
    UMRS 1138, Team 17, Centre de Recherche des Cordeliers, INSERM,, Paris, France
  • Francine F Behar-Cohen
    UMRS 1138, Team 17, Centre de Recherche des Cordeliers, INSERM,, Paris, France
    Department of ophthalmology, Jules-Gonin Eye Hospital, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships Jean-Louis Bourges, None; Michele Savoldelli, None; Francine Behar-Cohen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1567. doi:
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    • Get Citation

      Jean-Louis Bourges, Michele Savoldelli, Francine F Behar-Cohen; Wound healing of posterior corneal lamellea after mechanical or femtolaser precut DSEAK. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1567.

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

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Abstract

Purpose: To compare collagen lamellae at graft’s interface of corneas after femto-assisted (FLEK) or mechanically precut (DSEAK) endothelial keratoplasty.

Methods: We collected corneas from patients who underwent penetrating keratoplasty after failed FLEK or DSEAK. Corneas were embedded in glutaraldehyde and graft’s interfaces were observed on semi-thin sections and 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. Damaged collagen layers at the graft’s interface were semi-quantified in the 3 mm central corneal area with a 3 item-based scale (no, mild, severs).

Results: Ten corneas were harvested and analyzed (5 FLEK, 5 DSEAK). The procedures were indicated after non immune (3 FLEK, 4 DSEAK) or immune (1 FLEK, 1 DSEAK) secondary endothelial failure, and poor visual result (1 FLEK). In the analyzed area on the graft’s side, disrupted collagen fibrillae were systematically observed in FLEK. Recipients and DSEAK displayed normal or irregular arrangement of collagen lamellae, but no disrupted fibrillea was detectable. Endothelial lenticule samples were detached from the recipient cornea in 2/5 (partially) FLEK and 4/5 DSEAK (3 partially, 1 totally).

Conclusions: Collagen lamellae rearrangement is observed on both sides of FLEK and DSEAK interfaces, mainly caused by edema. Collagen fibrillae disruption is only observed after FLEK on the Femtolaser precut side of the graft, seems to enhance graft’s adhesion to the recipient stroma and contribute to poor visual outcomes reported after FLEK.

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