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Y. M. Khalifa, D. Davis, M. D. Mifflin, M. Moshirfar, N. Mamalis; Histopathologic Evaluation of LASIK Donor Corneal Caps in Descemet’s Stripping Automated Endothelial Keratoplasty Using a Microkeratome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):780.
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© ARVO (1962-2015); The Authors (2016-present)
To compare Descemet’s stripping automated endothelial keratoplasty (DSAEK) donor corneal caps from LASIK and non-LASIK donors and assess cut smoothness and LASIK flap stability.
Review of donor caps submitted for pathologic evaluation from 2005 through 2009 showed three LASIK donors and four non-LASIK donors. Tissue was prepared using an anterior chamber maintainer and Moria microkeratome. Specimens had been previously prepared with hematoxylin/eosin staining of slides following sectioning and processing for histopathologic evaluation. Examination of the LASIK flap interface and posterior cut smoothness was performed with light microscopy at 100X magnification in each specimen. Posterior cut smoothness was assessed centrally and peripherally by evaluating the number of frayed collagen fibers emanating from the posterior stromal surface. This was thought to be proportional to tissue planes invaded by the microkeratome. Corneal cap curvature and stromal thickness were likely altered by tissue processing, and therefore, were not used as comparison criteria. Comparison of smoothness was statistically analyzed between LASIK and non-LASIK donor groups with non-parametric assays.
Light microscopy revealed two of the three LASIK donor caps with large dehiscence of the flap, and the third with micro-dehiscence. Although the LASIK donor caps showed flap dehiscence anteriorly, the number of frayed posterior collagen fibers in LASIK vs. non-LASIK donor caps was not statistically significant centrally nor peripherally. Microkeratome cut smoothness appears similar between LASIK and non-LASIK donor caps.
LASIK donor tissue for DSAEK appears not to hinder microkeratome cut smoothness. The shearing force of the microkeratome pass does appear to create flap dehiscence.
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