Abstract
Abstract: :
Purpose: Artificial anterior chambers (AACs) are new in ophthalmology and eye–bank donor corneoscleral explants are not standardized globally, which results in intraoperative difficulties and failure of the AACs. We compared three AACs to determine the optimal size of donor corneoscleral tissue (DCST). Setting: Illinois Eye–Bank, Chicago. Methods: The AACs tested were Bausch & Lomb (B&L), Moria Hanna (MH), and Moria ALTK (MALTK). Twenty DCSTs were evaluated. The scleral skirt was measured from the limbus to the cut edge at 4 cardinal points (mean rim size, 3.14±0.61 mm; range, 2.07–4.19). DCSTs were mounted in the AACs, a target pressure of 65 mm Hg was set using Barraquer tonometer. Tissue slippage with seal rupture before reaching the target pressure was considered a failure. Results: The mean scleral rim sizes that maintained a seal and failed to maintain a seal, respectively, were 3.4±0.7 mm (range, 2.1–4.2) and 2.99±0.51 mm (range, 2.13–3.5). The B&L AAC had a 40% success rate and the MH and MALTK had 100% success rates (P<0.001). The mean scleral rims of the samples tested (B&L/MH/MALTK) were 3.14±0.61, 3.16±0.58, and 3.22±0.61 mm. Conclusions: Using Optimal Data Analysis (ODA) techniques, we found that the DCST should have a minimal scleral skirt of 3.6 mm for successful use in an AAC for lamellar or penetrating keratoplasty (epithelial approach). We identified the optimal value based on studying the corneas that would fail in the B&L chamber (P<0.07). MH and MALTK outperformed B&L AAC (P<0.001) consistently, with no tissue slippage observed with the MH and MALTK AACs.
Keywords: cornea: clinical science • transplantation • clinical (human) or epidemiologic studies: systems/equipment/techniques