March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Femtosecond Laser and Microkeratome Preparation of Ultrathin (UT) DSAEK Grafts. The first clinical results
Author Affiliations & Notes
  • Joaquim N. Murta
    Ophthalmology-Univ Hospital, Faculty Medicine, University Coimbra, Coimbra, Portugal
  • Andreia Rosa
    Ophthalmology-Univ Hospital, Faculty Medicine, University Coimbra, Coimbra, Portugal
  • Maria Quadrado
    Ophthalmology-Univ Hospital, Faculty Medicine, University Coimbra, Coimbra, Portugal
  • Sérgio Brito
    Ophthalmology-Univ Hospital, Faculty Medicine, University Coimbra, Coimbra, Portugal
  • Ana Cardoso
    Ophthalmology-Univ Hospital, Faculty Medicine, University Coimbra, Coimbra, Portugal
  • Footnotes
    Commercial Relationships  Joaquim N. Murta, None; Andreia Rosa, None; Maria Quadrado, None; Sérgio Brito, None; Ana Cardoso, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3136. doi:
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      Joaquim N. Murta, Andreia Rosa, Maria Quadrado, Sérgio Brito, Ana Cardoso; Femtosecond Laser and Microkeratome Preparation of Ultrathin (UT) DSAEK Grafts. The first clinical results. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3136.

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

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Abstract

Purpose: : To evaluate the use of a femtosecond laser and a mechanical microkeratome to prepare ultrathin posterior corneal disks for Descemet stripping automated endothelial keratoplasty (DSAEK) and to assess associated visual results, disk thickness and endothelial cell loss.

Methods: : This clinical study involved ultrathin DSAEK tissue preparation used in 13 patients with endothelial dysfunction.The first cut was performed with an Intralase FS60 laser and the second cut with a Moria CBm 300- microkeratome. The thickness of the first cut was modified for each cornea to obtain a final graft thickness of 120 µm. Post-op central graft thickness was performed with corneal laser tomography (Spectralis). Central endothelial cell density (ECD) was calculated before and 3 months after surgery.

Results: : Final graft thickness was 88.3+27.6 µm, 77.2+26.6 µm and 74.3+27.5 µm at one week, one and three months post-op, respectively. No loss of corneas due to irregular cuts or perforation during preparation. The mean BSCVA was 0.41, 0.52, and 0.72(0.39, 0.28 and 0.14 LogMAR) after one week, one and three months post-op, respectively. Precut and post-op (3 months) ECDs averaged 2553 cells/mm2 and 1882 cells/mm2, respectively, representing 26.3% endothelial cell loss after 3 months of the surgery.

Conclusions: : Femtosecond laser and microkeratome can be used sequentially to prepare custom ultrathin DSAEK grafts with no loss of corneas. This procedure minimizes the variability inherent to microkeratomes and allows very quick recovery of visual acuity after posterior lamellar keratoplasty

Keywords: cornea: endothelium • visual acuity 
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