Single-Pass Microkeratome System for Eye Bank DSAEK Tissue Preparation

PURPOSE: To evaluate the predictability and reproducibility of stromal bed thickness for single-pass donor Descemet stripping automated endothelial keratoplasty (DSAEK) tissue preparation, using the ML7 Microkeratome Donor Cornea System (Med-logics Inc, Athens, TX). METHODS: In this retrospective chart review of 256 consecutive corneal tissue preparations for DSAEK surgery, from June 2013 to August 2014, tissue thicknesses were divided into 3 groups, depending on surgeon preference: <91 μm (group A), 90 to 120 μm (group B), and 120 to 160 μm (group C). Precut and postcut data were recorded. RESULTS: Average postcut donor corneal thickness was 114 ± 30 μm (range 60-183 μm), whereas the average in group A was 97 ± 23 μm (range 60-128), in group B was 113 ± 21 μm (range 77-179), and in group C was 134 ± 43 (range 89-183). Average postcut endothelial cell density was very adequate at 3013 ± 250 cells per square millimeter. There were a total of 7 failed procedures from 256 attempts, which represents a rate of 2.7%. This rate decreases to 1.5% when analyzing the last 200 cuts. CONCLUSIONS: The ML7 Microkeratome Donor Cornea System allows for reliable and reproducible DSAEK tissue preparation. Ultrathin DSAEK tissues can be prepared with a single-pass. Aiming for a graft thickness between 90 and 120 μm seems to be most reliable.