Comparison of organ cultured precut corneas versus surgeon-cut corneas for Descemet’s stripping automated endothelial keratoplasty

Abstract

To compare precut and surgeon-cut organ cultured donor corneas for DSAEK. A total of 119 consecutive eyes treated with DSAEK were retrospectically identified. 65 grafts were cut by the surgeon (Moria, ALTK System) prior to DSAEK and 54 grafts were precut by laboratory technicians from the Danish Eye Bank (Horizon single-use system). 1year after surgery, tomographic images were obtained with the Pentacam HR. Endothelial cell density (ECD) and best-corrected visual acuity (BCVA) was determined. Graft thickness and graft asymmetry was evaluated in the centre and 1mm from the edge of the graft in 6 semi-meridians. 1year after surgery, the ECD loss was similar in the two groups, averaging 25.9±14% in surgeon-cut, and 22.9±17% in precut group (p=0.33). Mean central graft thickness was 172±6μm in surgeon-cut grafts and 182±6μm in precut grafts (p=0.30). BCVA was similar in surgeon-cut and precut corneas; being 0.25±0.02 logMAR and 0.24±0.02 logMAR, respectively (p=0.59). The graft asymmetry index was 1.48±0.02 for surgeon-cut and 1.44±0.02 for precut grafts. There were no significant differences in complications rate in both groups. No correlations between BCVA and central graft thickness or graft asymmetry index in both groups were observed. Organ cultured precut donor corneas are comparable with surgeon-cut grafts with respect to ECD, graft thickness and asymmetry, and postoperative complication rate.