Descemet stripping automated endothelial keratoplasty tissue preparation with femtosecond laser and contact lens

Takeshi Ide, Sonia H. Yoo, George D. Kymionis, Theodore Leng, Cecilia Marini, Natalie A. Stanciu, Terrence P. O'Brien

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Purpose: To report a novel method of preparing planar Descemet stripping automated endothelial keratoplasty (DSAEK) tissue using a femtosecond laser with a hyperopic soft contact lens (Hyp-SCL). Methods: DSAEK tissue was prepared from 11 cadaveric porcine eyes. A femtosecond laser was used to create 400-μm flaps, with or without a Hyp-SCL, after which the eyes were imaged with anterior segment optical coherence tomography. The ratio of the mean central thickness (C) to the mean peripheral thickness (P) was calculated using the flap tool. Results: Eleven eyes were cut (5 without, 5 with, and 1 without and with a Hyp-SCL). In all corneas, the cut interfaces were visualized by anterior segment optical coherence tomography. The mean C:P ratio of the flap made without a Hyp-SCL was 0.998 (range 0.968-1.03, SD = 0.254) compared with 0.904 (range 0.851-0.985, SD = 0.509) with a Hyp-SCL (P = 0.001), demonstrating that a cut made with a Hyp-SCL created a flap that was significantly more concave than that created without a Hyp-SCL, resulting in a more planar DSAEK graft. However, the C:P ratios calculated for DSAEK tissue made without (mean 0.998, range 0.965-1.02, SD = 0.0195) and with (mean 1.02, range 0.986-1.05, SD = 0.0250) a Hyp-SCL did not show significance (P = 0.07). Conclusions: Combining a femtosecond laser and a Hyp-SCL may aid in the creation of planar donor tissue for DSAEK. Clinically, this could reduce the amount of postoperative hyperopic shift, although further human corneal studies are warranted.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalCornea
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Descemet stripping automated endothelial keratoplasty
  • Femtosecond laser
  • Hyperopia
  • Refractive surprise
  • Soft contact lens

ASJC Scopus subject areas

  • Ophthalmology

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