Thin lenticule Descemet's stripping automated endothelial keratoplasty: single, slow pass technique

Abstract

To evaluate the outcomes of single pass thin lenticule sutureless Descemet's stripping automated endothelial keratoplasty with donor lenticules prepared using a 400 μm microkeratome head. Interventional case series. Cases with corneal endothelial dysfunction. Fifteen cases with corneal endothelial dysfunction (eight pseudophakic bullous keratopathy, three Fuchs' endothelial dystrophy, three congenital hereditary endothelial dystrophy and one failed graft) underwent thin lenticule Descemet's stripping automated endothelial keratoplasty at a tertiary care hospital. Donor lenticule was prepared with a single pass 400 μm Carriazo Barraquer microkeratome (Moria, Antony, France) head. Sutureless Descemet's stripping automated endothelial keratoplasty was performed in all the cases through a 3.5 mm corneoscleral tunnel using a Busin glide for graft insertion. Main parameters evaluated were postoperative donor lenticule thickness and best-corrected visual acuity. Donor lenticules were harvested successfully for all 15 cases without any complications. At 6-months follow up, the mean logMAR best-corrected visual acuity improved from 1.87 ± 0.52 to 0.109 ± 0.11 (P = < 0.0001). The mean donor lenticule thickness was 111 ± 17.62 μm (range 70-134 μm) at the last follow up. The mean endothelial cell loss was 26.33 ± 1.34%. Thin donor lenticules for Descemet's stripping automated endothelial keratoplasty can be safely harvested using a single pass technique with 400 μm microkeratome head and can be used for a successful Descemet's stripping automated endothelial keratoplasty surgery.