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Juan A. Duran, Arturo E. Grau, Mikel García; Femtosecond Assisted Technique In The Donor Harvesting For Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2012;53(14):34.
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To describe a new harvesting technique to obtain a corneal graft for endothelial keratoplasty.
The donor cornea is placed in an artificial anterior chamber and its apex is marked with a pen. After pachymetry at the 8-9 mm corneal diameter, the femtolaser (IntraLase™) suction ring is docked to the applanation cone. Ring tunneling is performed with the following laser settings: outer diameter 9.0 mm; inner diameter 7.7 mm; depth 450-500 µm; ring energy 170 mJ. A custom-designed hook (outer diameter 8.3 mm; inner diameter 6.8 mm; a small hole near the tip, and an arch length of 320º) which has been threaded with a 6/0 nylon suture is then passed through the tunnel. Corneal delamination is achieved by applying traction to the suture. The delamination is enlarged towards the periphery with a spatula.Once the cornea was punched, the anterior interface was studied under SEM, to analize the quality of the interface.
We have studied the characteristics of the buttons in 12 eyes from 12 patients. In all cases, a homogeneous thin graft was obtained, without perforation or loss of the lamellar plane.
With this technique, we can reliably obtain a graft for endothelial keratoplasty, with predictable thickness and shape characteristics.
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