June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Tears of post-LASIK corneal donor tissue during surgeon-performed donor graft preparation for DSAEK
Author Affiliations & Notes
  • Drew Davis
    Medical College of Wisconsin, Wauwatosa, IN
  • Peter Karth
    Medical College of Wisconsin, Wauwatosa, IN
  • Christopher Croasdale
    Ophthalmology, Davis Duehr Dean Clinic, Madison, WI
    University of Wisconsin School of Medicine and Public Health, Madison, WI
  • Steven Koenig
    Medical College of Wisconsin, Wauwatosa, IN
  • Footnotes
    Commercial Relationships Drew Davis, None; Peter Karth, None; Christopher Croasdale, None; Steven Koenig, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3088. doi:https://doi.org/
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      Drew Davis, Peter Karth, Christopher Croasdale, Steven Koenig; Tears of post-LASIK corneal donor tissue during surgeon-performed donor graft preparation for DSAEK. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3088. doi: https://doi.org/.

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

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Abstract

Purpose: To describe four cases by two different surgeons in which tears or tissue damage occurred during surgeon-performed preparation of the posterior lamellar corneal lenticule in post-laser assisted in situ keratomileusis (LASIK) corneal donor tissue for Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: In this retrospective case series, all donor corneal tissues had previously undergone LASIK surgery. In all cases, a Moria® artificial anterior chamber maintainer (Moria, Doyleston, PA) and a Moria® ALTK microkeratome (300-um-depth) was used by the surgeon to separate the lamellar corneal tissue.

Results: In all four cases, the post-LASIK corneal donor tissues were torn or damaged during preparation. In two cases, large tears of the posterior lamella occurred during surgeon preparation of the donor lenticule with a microkeratome, and the tissue was deemed unusable. One case was subsequently canceled immediately prior to planned DSAEK; in the second case, an additional donor cornea was available and was successfully transplanted. In the third and fourth cases, the tissue was damaged but was deemed usable. A button-hole perforation occurred in the anterior lamellar cap of the third case, and a linear paracentral ridge was inadvertantly created on the posterior lamella of the donor tissue in the fourth case.

Conclusions: While published literature supports use of post-LASIK donor corneal tissue in DSAEK, we believe that our cases demonstrate a need for caution in surgeon preparation of post-LASIK donor corneal tissue. To avoid tissue waste and cancelled procedures, we recommend post-LASIK donor tissue be prepared in the laboratory prior to the planned procedure. As more potential corneal donors undergo LASIK each year, effective preparation of post-LASIK donor corneal tissue will become an increasingly important consideration.

Keywords: 479 cornea: clinical science • 683 refractive surgery: LASIK • 741 transplantation  
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