Tissue quality of eye-bank–prepared precut corneas for Descemet’s stripping automated endothelial keratoplasty

Abstract

ObjectiveTo evaluate endothelial cell density (ECD) of eye-bank–prepared tissue for use in Descemet’s stripping automated endothelial keratoplasty (DSAEK). DesignProspective case series of consecutive corneal tissue prepared for DSAEK surgery. ParticipantsSixty-seven sequential corneal-scleral tissue specimens representing 48 human donors processed for use in DSAEK surgery by the Regional Tissue Bank (Halifax, Nova Scotia). MethodsCorneal-scleral donor tissue was obtained by in situ recovery. ECD was recorded using the EB-3000 XYZ (HAI Laboratories Inc, Lexington, MA) specular microscope within 24 hours of preservation. Before the tissue was dissected, the corneal thickness was measured using the DGH-550 PACHETTE 2 (DGH Technology, Exton, PA) ultrasound pachymeter. The dissection was performed using a 300-μm Moria ALTK model microkeratome (Moria Inc). The posterior bed thickness was measured, and the anterior flap was replaced. Endothelial cell count density was obtained after re-preservation. ResultsComplete measurements were obtained for 42 of 67 corneas. In 25 corneas it was not possible to obtain a postdissection ECD measurement. The mean ECD before dissection was 2806 ± 317 cells/mm2. The mean ECD after dissection was 2772 ± 318 cells/mm2. There was an average loss of 34 cells/mm2 (95% CI –110 to 40 cells/mm2, p = 0.3). ConclusionsThis case series confirms that ECD is preserved when DSAEK tissue is prepared in advance of surgery by trained eye-bank technicians in a low-volume Canadian eye bank. It was difficult to obtain clear images of the endothelial cell layer postdissection, possibly because of tissue swelling or distortion. Sixty-six of 67 corneas included in the study were used for surgery.