Tissue quality of eye-bank-prepared precut corneas for Descemet's stripping automated endothelial keratoplasty.

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

PubMedID: 24513364

Nelson BA, Ritenour RJ. Tissue quality of eye-bank-prepared precut corneas for Descemet's stripping automated endothelial keratoplasty. Can J Ophthalmol. 2014;49(1):92-5.
OBJECTIVE
To evaluate endothelial cell density (ECD) of eye-bank-prepared tissue for use in Descemet's stripping automated endothelial keratoplasty (DSAEK).

DESIGN
Prospective case series of consecutive corneal tissue prepared for DSAEK surgery.

PARTICIPANTS
Sixty-seven sequential corneal-scleral tissue specimens representing 48 human donors processed for use in DSAEK surgery by the Regional Tissue Bank (Halifax, Nova Scotia).

METHODS
Corneal-scleral donor tissue was obtained by in situ recovery. ECD was recorded using the EB-3000 XYZ (HAI Laboratories Inc, Lexington, MA) specular microscope within 24 hours of preservation. Before the tissue was dissected, the corneal thickness was measured using the DGH-550 PACHETTE 2 (DGH Technology, Exton, PA) ultrasound pachymeter. The dissection was performed using a 300-µm Moria ALTK model microkeratome (Moria Inc). The posterior bed thickness was measured, and the anterior flap was replaced. Endothelial cell count density was obtained after re-preservation.

RESULTS
Complete measurements were obtained for 42 of 67 corneas. In 25 corneas it was not possible to obtain a postdissection ECD measurement. The mean ECD before dissection was 2806 ± 317 cells/mm(2). The mean ECD after dissection was 2772 ± 318 cells/mm(2). There was an average loss of 34 cells/mm(2) (95% CI -110 to 40 cells/mm(2), p = 0.3).

CONCLUSIONS
This case series confirms that ECD is preserved when DSAEK tissue is prepared in advance of surgery by trained eye-bank technicians in a low-volume Canadian eye bank. It was difficult to obtain clear images of the endothelial cell layer postdissection, possibly because of tissue swelling or distortion. Sixty-six of 67 corneas included in the study were used for surgery.