Reproducibility of single-pass donor DSAEK tissue preparation with the MORIA single-use microkeratome

Abstract

Purpose: To assess the reproducibility of single-pass cutting for preparation of ultra-thin (≤120μm) donor cornea grafts in Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: All consecutive patients of DSAEK performed using the MORIA One Use microkeratome (MORIA, Antony, France) in between June 2014 and August 2015. Patient and donor central corneal thickness (CTT), microkeratome head, remaining stromal bed thickness (RSBT), number of cut and graft thickness at 1 month and 6 months postoperatively were recorded in this single-center prospective study.

Results: The mean preoperative donor graft CCT was 569.0±45.1μm and the mean donor endothelial graft CCT immediately after the cut was 116.5±28.7μm. At 1 month postoperatively, the mean CCT was 102.8±35.9μm. At 6 months, the mean CCT was 89.4±26.2μm. In all eyes, the mean CCT decreased from the post-cut (116.5±28.7μm) to the last visit (89.4±26.2μm) (P<0.01) due to in vivo deturgesence of the graft. We obtained 77.5% ultra-thin DSAEK immediately after the cut, 77.5% at 1 month and 89.8% after 6 months.

Conclusion: Single-pass technique with the MORIA One Use microkeratome offers safe and reproducible DSAEK tissue preparation and allows achieving ultra-thin DSAEK in 89.8% of cases.

Keywords: Biomécanique cornéenne; Corneal biomechanics; DSAEK; Endothelial keratoplasty; Graft thickness; Greffe endothéliale; Greffe lamellaire; Lamellar keratoplasty; Microkeratome; Microkératome; Simple découpe; Single-pass technique; Épaisseur du greffon.