Single-Pass Mikrokeratome and Anterior Chamber Pressurizer for the Ultrathin Descemet-Stripping Automated Endothelial Keratoplasty Graft Preparation.

Autor:	Clerici R; Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia, Pavia, Italy., Ceccuzzi R; University Eye Clinic, Foundation and IRCCS San Matteo Hospital, Pavia, Italy., Fausto R; Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia, Pavia, Italy., Tinelli C; Clinical Epidemiology and Biometric Unit, Foundation and IRCCS San Matteo Hospital, Pavia, Italy., Di Palma MR; University Eye Clinic, Foundation and IRCCS San Matteo Hospital, Pavia, Italy., Mantegna G; University Eye Clinic, Foundation and IRCCS San Matteo Hospital, Pavia, Italy., Riva I; IRCCS - Fondazione GB Bietti, Rome, Italy., Busin M; Department of Ophthalmology, Ospedali Privati Forlì, Forlì, Italy.; IRFO, Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì̀, Italy; and.; Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy., De Angelis G; Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia, Pavia, Italy., Quaranta L; Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia, Pavia, Italy.; University Eye Clinic, Foundation and IRCCS San Matteo Hospital, Pavia, Italy.
Jazyk:	angličtina
Zdroj:	Cornea [Cornea] 2021 Jun 01; Vol. 40 (6), pp. 755-763.
DOI:	10.1097/ICO.0000000000002607
Abstrakt:	Purpose: To compare the reliability of microkeratome dissection with the anterior chamber pressurizer (ACP) system versus conventional pressurization for ultrathin Descemet-stripping automated endothelial keratoplasty (UT-DSAEK) graft preparation. Methods: A retrospective review of a consecutive series of dissected donor corneas processed at Pavia Eye Bank for UT-DSAEK surgery was performed. Grafts were prepared through single-pass microkeratome dissection with artificial anterior chamber internal pressure regulation through either ACP or the conventional method using a water column with tube clamp. The target central graft thickness (CGT) was ≤100 μm. Cutting predictability was determined as the difference between the microkeratome head size and the thickness actually removed. Graft regularity was investigated as central-to-peripheral thickness increase, central-to-peripheral (CP) ratio, and graft thickness uniformity. Thickness was measured with anterior segment optical coherence tomography (horizontal and vertical meridians). Results: Of the 265 UT-DSAEK grafts, ACP achieved the target "CGT ≤ 100 μm" in 87 of 120 (72.5%), whereas the conventional technique achieved the same in 85 of 145 (58.6%) (P = 0.018). ACP predictability was -3.9 μm (SD: 2.3), whereas predictability of the conventional technique was -54.6 μm (SD: 3.7) (P < 0.001). Thickness increased similarly (P = 0.212); CP ratio was better with ACP for only 2 mm diameter (P = 0.001); graft thickness uniformity was comparable (P > 0.05). Conclusions: Compared with conventional pressurization, ACP improved microkeratome-assisted preparation reliability of UT-DSAEK grafts, achieving CGT ≤ 100 μm with significantly higher frequency (P = 0.018) and predictability (P < 0.001). ACP improved CP ratio only at 2 mm (P = 0.001); for other graft thickness, the 2 methods proved equivalent. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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