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Zachary Mayko, Cor van Zyl, Michael D Straiko, Mark A Terry; Projecting DSAEK Graft Thickness: Grafts up to 140 µm preoperatively predictably become ultrathin (100 µm). Invest. Ophthalmol. Vis. Sci. 2014;55(13):888.
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© ARVO (1962-2015); The Authors (2016-present)
To report clinically significant thinning of DSAEK grafts from “thin” preoperatively to “ultrathin” 3 or more months postoperatively. To determine if there is a threshold preoperative thickness that would guarantee postoperative thicknesses less than 100 microns.
Retrospective review of 90 consecutive DSAEK grafts thinning over time. Ocular coherence tomography (OCT) was used to measure graft thickness both preoperatively and at postoperative time points between 3 and 9 months to determine thinning. Grafts were also clustered into decile groups of preoperative thickness and then postoperative thinning between decile groups were compared.
Preoperative graft thickness averaged 143 µm with a range of 66 um to 215 um. Mean postoperative thickness was 108 µm, representing an average thinning of 23%. In the 41 grafts with preoperative thickness of less than 140 um, 90% thinned down to less than 100 µm postoperatively. Conversely, only 8% (4/50) grafts with preoperative thicknesses greater than 140 µm thinned to less than 100 µm. Only a minor amount of graft thinning was observed in groups with initial thicknesses under 110 µm (16%) and plateauing in grafts 110 µm and greater (25%).
Some studies have found that donor grafts that are less than 100 um POSTOPERTIVELY may result in better vision. Surgeons desiring these results can confidently request grafts with preoperative thicknesses up to 140 µm thick from the eye bank and be assured that they are transplanting tissue that will ultimately be ultrathin postoperatively. In addition, grafts thinner than 110 um preoperatively have less percentage thinning than grafts thicker than 110 um.
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