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M. C. Aguilar, D. Amato, D. S. Lomoriello, M. L. Livani, S. Yoo, J.-M. Parel, A. Pocobelli; Clinical Follow-Up of Ultra-Thin Pre-Cut Tissue Prepared With a New Media for DSAEK. Invest. Ophthalmol. Vis. Sci. 2010;51(13):742.
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To study corneal donor characteristics in patients undergoing Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) surgery, at 15 days and 6 months, using tissue prepared in eye banks (EB) with a novel medium that significantly reduces the donor corneal thickness before the microkeratome cut.
Twenty-one eyes of 21 patients with endothelial dysfunction due to Fuchs’ endothelial dystrophy and pseudophakic bullous keratopathy received transplants at S.Giovanni-Addolorata-Britannico Hospital, Rome, Italy. All donor tissues were "de-swelled" by immersion in Thin-C media (Al.Chi.Mi.A, SRL, Italy), a solution designed for reducing corneal thickness (4 days max storage time), for 4 hours at 4°C. AS-OCT (VisanteTM, Carl Zeiss Medic Inc., Dublin, CA, USA) was done using a custom-made adaptor and confocal microscopy analyses was performed to record donor corneal thicknesses, endothelial cellular density, and morphology.
After 4 hours, before the microkeratome cut, Thin-C reduced the donor corneal thickness on an average of 100 um. After microkeratome cut, on 20 donor tissues, the residual thickness of 10 donor corneas was between 115 and 195 um and in the other 10 corneas, between 200 and 220 um. After 7 days the thickness decrease was 13% on average and after 6 months, 30%. Endothelial cell density decreased on average by 43% after 6 months. Postoperatively, there was one graft failure (4.8%) at 1 month due to intraoperative complications.
The opportunity to significantly reduce the donor corneal thickness, using a novel medium especially designed for EB pre-cut tissues, offers the advantage to prepare very thin lenticules for DSAEK without complications to patients.
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