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Nomogram for single-pass automated microkeratome graft preparation for ultrathin Descemet stripping automated endothelial keratoplasty

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Abstract

Purpose

To create a nomogram including the translational speed of the microkeratome blade, microkeratome head size and precut tissue thickness to predict the postcut thickness for Descemet stripping automated endothelial keratoplasty to obtain the thinnest possible graft.

Methods

This prospective study incorporated 48 grafts for DSAEK from March 2017 to June 2020. Corneal tissue for DSAEK was prepared by 3 experienced physicians using the Moria Evolution 3E (Moria Inc, Antony, France) microkeratome with 400, 450 and 500 μm head sizes. Precut central corneal thickness was measured with a DGH 550 handheld pachymeter (Pachette 2), taking an average of 3 readings. The microkeratome head was selected according to precut tissue thickness. The selected microkeratome head size was 150 μm less than the donor cornea thickness. Two translational speeds were used for the microkeratome cuts. One month after surgery, the central lenticular thickness was measured with a Visante® Optical Coherence Tomography caliper (Carl Zeiss Meditec Inc, Germany). A descriptive analysis was performed.

Results

Forty-eight donor grafts were prepared. Mean graft thickness was 97.58 ± 29.84 μm (range 39–176 μm). Of the 48 samples, central graft thickness was < 120 µm (81.3%) in 39, < 100 µm (58.3%) in 28 and < 80 µm (37.5%) in 18 at 1-month follow-up. There were no statically significant differences between translational speeds.

Conclusions

A nomogram with an automated microkeratome to obtain thin grafts for DSAEK provided good graft thickness results without donor waste.

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Funding

This study was not funded by any institution or organization or any other funding body.

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Authors and Affiliations

  1. Instituto de Oftalmología la Arruzafa, Avenue la Arruzafa 9, 14012, Córdoba, Spain

    Álvaro Sánchez-Ventosa, Antonio Cano-Ortiz, Timoteo González-Cruces, Vanesa Díaz Mesa & Alberto Villarrubia

  2. Clínica Baviera Málaga, Málaga, Spain

    Pablo Morales

Authors
  1. Álvaro Sánchez-Ventosa
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  2. Antonio Cano-Ortiz
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  3. Pablo Morales
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  4. Timoteo González-Cruces
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  5. Vanesa Díaz Mesa
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  6. Alberto Villarrubia
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Corresponding author

Correspondence to Antonio Cano-Ortiz.

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All authors declare no conflict of interest with any of the stated materials in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sánchez-Ventosa, Á., Cano-Ortiz, A., Morales, P. et al. Nomogram for single-pass automated microkeratome graft preparation for ultrathin Descemet stripping automated endothelial keratoplasty. Int Ophthalmol 42, 989–995 (2022). https://doi.org/10.1007/s10792-021-02082-8

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  • DOI: https://doi.org/10.1007/s10792-021-02082-8

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