Work

Comparative Study of Descemet Stripping Automated Endothelial Keratoplasty Donor Preparation by Moria CBm Microkeratome, Horizon Microkeratome, and Intralase FS60

Year: 2010

Type: article

Abstract: Purpose-To evaluate the quality of stromal bed and the safety on endothelium in preparation of donor tissue for Descemet stripping automated endothelial keratoplasty in a masked fashion using 2 mechanical microkeratomes and a femtosecond laser.Methods-Deep anterior lamellar dissection was performed on 15 donor corneas.Central endothelial cell density was calculated using specular microscopy before and after the dissection.One cornea from each of 5 donor pairs was cut with the Moria ALTK system with the CBm microkeratome using the 300-μm head and the mate cut with the Horizon disposable 300-μm microkeratome.Five additional donor corneas were cut with the Intralase 60-kHz FS laser.The donor corneas were then bisected with half of the cornea used for Live/Dead assay to study central endothelial viability.The other halves were sent for scanning electron microscopy of the stromal bed.Qualitative surface roughness of the scanning electron microscopy images was graded by 2 masked observers, and quantitative surface roughness was assessed using roughness evaluation software.Results-The Horizon group showed a smoother stromal bed compared with the Moria or Intralase groups by 2 masked observers.However, the Moria group had the smoothest quantitative score of all the groups when assessed by roughness evaluation software.There was no statistically significant difference among the 3 groups in the percentage change in the central endothelial cell density or percentage of viable central endothelium by Live/Dead assay after the dissection.Conclusions-Both mechanical microkeratomes created smoother stromal bed dissections than the femtosecond laser.All systems provided good endothelial cell viability.

Source: Cornea

DOI: 10.1097/ico.0b013e3181e29188