Lamellar Keratoplasty with a Novel Anterior Chamber System and Organ Cultured Donor Corneas

Abstract

To present a novel artificial anterior chamber system for anterior and posterior lamellar keratoplasty. The artificial anterior chamber system MOZARTTM in conjunction with the AMADEUSTM II microkeratome was evaluated for its applicability in anterior and posterior lamellar keratoplasty using organ cultured donor corneas. Twelve patients underwent microkeratome-assisted lamellar keratoplasty for corneal opacifications due to either anterior stromal scaring or endothelial decompensation. Eight patients underwent Descemet stripping automated endothelial keratoplasty (DSAEK) and 4 patients underwent anterior lamellar keratoplasty (ALK). A 400-microm and 250-microm cutting head was used for DSAEK and ALK, respectively. In all patients, an 8.5-mm suction ring was applied. For the 250-microm cutting head, a mean anterior lamella thickness of 244+/-12 microm was found. For the 400-microm cutting head, a mean anterior lamella thickness of 390+/-18 microm was found. The graft diameter was 8.85+/-0.5 mm for the 8.5-mm suction ring with both cutting heads. Deswelling of the anterior donor lamella was 11.5% compared to 30% of the posterior lamella transplant after 6 months of follow-up. The AMADEUSTM II microkeratome in conjunction with the MOZARTTM artificial anterior chamber system proved to be a suitable device for modern lamellar keratoplasty. Swelling and deswelling characteristics of organ cultured corneas need to be further investigated to optimize the deswelling time prior to donor cornea sectioning in lamellar keratoplasty.