May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Microkeratome–assisted posterior keratoplasty using infant donor cornea tissue
Author Affiliations & Notes
  • C.E. Kloek
    Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, MA
  • K.A. Colby
    Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, MA
    Ophthalmology, Schepens Eye Research Institute, Boston, MA
  • D.T. Azar
    Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, MA
    Ophthalmology, Schepens Eye Research Institute, Boston, MA
  • Footnotes
    Commercial Relationships  C.E. Kloek, None; K.A. Colby, None; D.T. Azar, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 2901. doi:
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      C.E. Kloek, K.A. Colby, D.T. Azar; Microkeratome–assisted posterior keratoplasty using infant donor cornea tissue . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2901.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:To report the results of a case series of four patients who underwent microkeratome–assisted posterior keratoplasty using infant donor corneal tissue. Methods:A retrospective case series was performed on four eyes of four patients with Fuchs’ dystrophy. A microkeratome was used to create a hinged anterior corneal flap in the host cornea prior to the day of surgery. On the day of surgery, donor tissue was prepared using a dedicated artificial anterior chamber and an excimer laser. In the operating room, the anterior corneal flap of the host was reflected and the posterior stromal tissue and endothelium were excised by trephination. The donor tissue was secured to the host cornea using 10–0 nylon or vicryl sutures. The hinged anterior flap was replaced over the donor button and sutured with 10–0 nylon. Two patients underwent concurrent phacoemulsification with posterior chamber lens implantation. Results:Donor age ranged from 4 months to 3 years, with an average pre–operative endothelial cell count of 4466 mm2. At six and twelve months after surgery the four grafts were clear and well positioned. No ectasia developed in any of the grafts. At 6–month follow–up best–corrected visual acuity (BCVA) ranged from 20/20 to 20/100. The average topographic astigmatism was 3.44 diopters (D), ranging from 2.8D to 4.2D. At 12–month follow–up the BCVA ranged from 20/20 to 20/80. Post–operative endothelial cell viability was assessed by pachymetry and specular microscopy. Post–operative pachymetry measurements on three patients one year post–operatively were 420–430 µm. Mean endothelial cell count in two patients at one year was 2650 cell/mm2. Complications included one episode of acute rejection responsive to steroids, and one episode of epithelial ingrowth treated by re–lifting the flap and scraping the corneal surface. One patient required resuturing of the donor button one week post–operatively. Conclusions:Infant donor cornea tissue can be used in microkeratome–assisted posterior keratoplasty without the development of corneal ectasia. Infant donor cornea tissue has extremely high endothelial cell density, and thus has the potential for allowing longer graft survival in endothelial dysfunction.

Keywords: cornea: endothelium • cornea: clinical science 
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