Anterior Corneal Buttons From DSAEK Donor Tissue Can Be Stored in Optisol GS for Later Use in Tectonic Lamellar Patch Grafting

Abstract

The aim of this study was to evaluate the feasibility of storing anterior corneal buttons split from donor Descemet stripping automated endothelial keratoplasty (DSAEK) tissue for later use in tectonic lamellar patch grafting. Donor corneas for DSAEK were split into anterior and posterior lamellae using a 350-μm depth microkeratome, and the remaining anterior corneal buttons were stored for up to 4 weeks at 4°C in Optisol GS before use in patch grafting of the cornea and sclera. Optisol GS-preserved anterior lamellar patch grafts successfully restored and maintained corneoscleral integrity after the removal of limbal dermoids (5 cases), after the coverage of the exposed polypropylene suture ends of scleral fixated posterior chamber intraocular lenses (2 cases), corneoscleral melting after pterygium excision (3 cases), sterile corneal ulceration with or without perforation (5 cases), Mooren ulceration (3 cases), and pseudomonas corneal ulceration with impending perforation (1 case). It was also used as a temporary substitute while waiting for a full-thickness corneal graft in a fulminant candida infection after DSAEK (1 case). All grafts remained structurally intact at the last postoperative examination of 19.2 ± 7.6 months after the tectonic surgery. Anterior corneal buttons from DSAEK donor tissue may be stored in Optisol GS for later use in tectonic patch grafting. This method obviates the longer operating time required for the surgeon to manually dissect the donor cornea in the operating room and reduces the wastage of precious donor corneas in countries where there are chronic shortages of eye bank donor tissue.