The effect of anterior chamber pressure and corneal drying on corneal thickness in preparation for descemet stripping endothelial keratoplasty (DSAEK).

Abstract

 

Purpose

 

To investigate the effect of anterior chamber pressure and corneal drying on graft thickness in graft preparation for DSAEK.

 

Methods

 

Corneoscleral discs were placed in an artificial anterior chamber (AAC). AAC pressure (15mmHg, 45mmHg, 92mmHg, 109mmHg and 198mmHg) was controlled using the height of an infusion bottle and a clamp. Corneas were exposed or repeatedly dried at 1minute intervals using cellulose spears. The endothelium was removed in one group. 3 corneas were used for each condition. Central corneal thickness was measured independently by two observers every 90 seconds for the first 15 minutes and every 5 minutes for the next 10 minutes using an ultrasound pachymeter (SP-100, Tomey).

 

Results

 

There was a significant inverse linear relationship between corneal thickness, AAC pressure and corneal drying (Table). . Removal of corneal endothelium reduced the rate of corneal thinning.

 

Conclusions

 

Increasing AAC pressure and corneal drying reduce graft thickness at predictable rates. For higher pressures and drying, the rate of thinning lay between narrow 95% confidence intervals, providing a reliable method to reduce corneal thickness in the preparation of grafts for DSAEK.