Dual-purpose corneal tissue for anterior lamellar keratoplasty and Descemet’s membrane endothelial keratoplasty

Abstract Objective To assess the intraoperative issues and surgical outcomes of preparing a single-donor corneal tissue for same-day use in both deep anterior lamellar keratoplasty (DALK) and Descemet’s membrane endothelial keratoplasty (DMEK). Design Consecutive retrospective case series. Participa...

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Bibliographic Details
Published in:Canadian journal of ophthalmology 2016-12, Vol.51 (6), p.408-411
Main Authors: Menant-Tay, C. Larena, BSc, Conlon, Ronan, MD, Teja, Salina, MD, Yeung, Season, MBBS, FRANZCO, Teichman, Joshua, MD, MPH, FRCSC, Ziai, Setareh, MD, FRCSC, Baig, Kashif, MD, MBA, FRCSC
Format: Article
Language:English
Subjects:
Aged
Canada
Cornea
Corneal Diseases - surgery
Corneal Transplantation - methods
Descemet Stripping Endothelial Keratoplasty - methods
Donor Selection
Female
Humans
Internal Medicine
Intraoperative Complications
Male
Middle Aged
Ophthalmology
Postoperative Complications
Retrospective Studies
Time Factors
Tissue and Organ Procurement
Tissue Donors
Visual Acuity
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Summary:Abstract Objective To assess the intraoperative issues and surgical outcomes of preparing a single-donor corneal tissue for same-day use in both deep anterior lamellar keratoplasty (DALK) and Descemet’s membrane endothelial keratoplasty (DMEK). Design Consecutive retrospective case series. Participants Ten eyes of 10 patients who underwent DALK (5 patients) or DMEK (5 patients) surgery using dual-purpose corneal tissue. Methods Five dual-purpose corneoscleral rims were used to prepare tissue for 5 DMEK and 5 DALK procedures. The submerged cornea using backgrounds away technique was first used to harvest the 5 DMEK grafts, and the remaining tissue was used for the 5 DALK grafts. Tissue preparation and operative use occurred on the same day. Tissue preparation challenges, intraoperative complications, and visual recovery were assessed. Results There were no difficulties in preparing the 5 dual-purpose tissues, and all 10 lamellar transplants were completed successfully. At the 6-month follow-up, the mean best-corrected distance visual acuity improved from 20/250 to 20/80 in the DALK patients, and from 20/300 to 20/25 in the DMEK patients. Postoperative complications after DALK included retained viscoelastic agent at the interface in 1 patient and a double anterior chamber managed with rebubbling in another. After DMEK, a peripheral partial graft detachment occurred in 1 patient and was managed successfully with rebubbling. All corneas demonstrated clarity on slit-lamp examination. Conclusions Single-donor corneal tissue can be effectively used for both DALK and DMEK, and may represent a more efficient use of corneal tissue. Complications with the preparation of dual-purpose tissue were not encountered.
ISSN:0008-4182
1715-3360
DOI:10.1016/j.jcjo.2016.05.005