Surface Metrology and 3-Dimensional Confocal Profiling of Femtosecond Laser and Mechanically Dissected Ultrathin Endothelial Lamellae

Dickman, Mor M.; Maris, M.P.F.H.L. van; Marion, Friso W van; Schuchard, Yvonne; Steijger-Vermaat, Petra; Biggelaar, Frank J H M van den; Berendschot, Tos T. J. M.; Nuijts, Rudy M.M.A.

doi:10.1167/iovs.14-14309

Cited by 7 publications

(7 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The DSAEK donor tissue was then dissected using a Gebauer SLc microkeratome (Gebauer Medizintechniek GmbH, Neuhausen, Germany) using the single‐pass technique, with the goal of achieving a central residual stromal bed thickness of 100 ± 40 μ m for ultrathin DSAEK (Dickman et al. , ). The donor (pre‐dissection) and lamellar (post‐dissection) central corneal thickness values were measured using a Casia SS‐1000 anterior segment OCT (Tomey, Nagoya, Japan).…”

Section: Methodsmentioning

confidence: 99%

Prospective evaluation of clinical outcomes between pre‐cut corneal grafts prepared using a manual or automated technique: with one‐year follow‐up

Muijzer

Luijk

Bogaerdt

et al. 2019

Acta Ophthalmologica

View full text Add to dashboard Cite

PurposePosterior lamellar corneal surgery is considered the standard of care for irreversible endothelial cell dysfunction. Pre‐cut grafts can be prepared either manually (Descemet stripping endothelial keratoplasty; DSEK) or mechanically (Descemet stripping automated endothelial keratoplasty; DSAEK). We performed a head‐to‐head clinical comparison between DSEK and DSAEK grafts.MethodsAll DSEK and DSAEK procedures performed by two corneal specialists at the University Medical Center Utrecht from 1 January 2016 through 31 October 2016 were prospectively included. Pre‐cut grafts were delivered by two eye banks, which either exclusively prepared the DSEK or DSAEK grafts. Preoperative and postoperative measurements were obtained, and all surgical events and adverse events were recorded.ResultsA total of 21 DSEK and 53 DSAEK procedures were included for analysis; the two groups were similar at baseline, with the exception of graft endothelial cell density, which was 2531 ± 67 versus 2748 ± 148 cells/mm2, respectively (p < 0.001). At the one‐year follow‐up visit, corrected distance visual acuity and endothelial cell loss were similar between the groups. Mean pachymetry was significantly lower in the DSEK group (521 ± 39 versus 588 ± 59 μm; p < 0.001), whereas the rebubbling rate was significantly higher in the DSEK group (47.6% versus 18.9%; p = 0.001). Finally, three grafts in the DSEK group experienced failure compared to one graft in the DSAEK group (14% versus 1.9%, respectively).ConclusionManually dissected and microkeratome‐dissected grafts performed similarly with respect to vision and endothelial cell loss assessed one year after surgery. The higher incidence of graft failure among manually dissected (i.e. DSEK) grafts may be attributable to reduced relative thickness compared to DSAEK grafts and/or the resulting differences in tissue handling and the surgeon's learning curve.

show abstract

Section: Methodsmentioning

confidence: 99%

Prospective evaluation of clinical outcomes between pre‐cut corneal grafts prepared using a manual or automated technique: with one‐year follow‐up

Muijzer

Luijk

Bogaerdt

et al. 2019

Acta Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…After a short hypothermic storage between recovery and arrival at the bank, corneoscleral buttons were dissected and stored in organ culture comprising minimum essential medium (Biowest, Nuaillé, France) supplemented with 25 mmol/l 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid, 26 mmol/l sodium bicarbonate, 5.5 mmol/l glucose, 2 mmol/l L-glutamine, 1 mmol/l pyruvate, 2% (vol/vol) newborn calf serum, 10 IU/ml penicillin, 0.1 mg/ml streptomycin, and 0.25 mg/ml amphotericin at 31 C. To allow deturgescence, corneoscleral buttons were transferred to a transport medium supplemented with 6% dextran (Sigma Aldrich, St. Louis, MO) before and immediately after dissection. Graft dissection was performed with the Gebauer SLc microkeratome system (Gebauer Medizintechniek GmbH, Neuhausen, Germany) using a single-pass technique, 12,13 aiming at a central residual stromal bed thickness of 200AE20 mm for DSAEK and 100AE20 mm for UT-DSAEK. Donor and lamellar central corneal thickness were measured at the cornea bank using anterior-segment optical coherence tomography (AS-OCT; Cassia SS-1000; Tomey, Nagoya, Japan).…”

Section: Donor Preparationmentioning

confidence: 99%

A Randomized Multicenter Clinical Trial of Ultrathin Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) versus DSAEK

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…To date there have been a number of articles investigating this. [6][7][8][9][10][11][12][13][14][15] Several authors have developed subjective (observer based grading) and objective (e.g. texture analysis) scores to quantify the smoothness of stromal beds using primarily scanning electron microscopy (SEM) images for comparison.…”

Section: Scanning Electronic Microscopy Evaluation Of the Roughness Omentioning

confidence: 99%

Scanning Electronic Microscopy Evaluation of the Roughness of the Stromal Bed After Deep Corneal Cut with the LDV Femtosecond Laser (Z6) (Ziemer) and the ONE Microkeratome (Moria)

Varga

Bergin

Roy³

et al. 2016

Current Eye Research

View full text Add to dashboard Cite

Purpose: To compare the stromal bed surface quality and the accuracy of dissection depth after deep lamellar cuts using the Leonardo Da Vinci (LDV) femtosecond laser (Z6) and the ONE Microkeratome. Methods: Deep lamellar cuts were performed on nine human donor corneoscleral buttons: five with the LDV femtosecond (FS) laser (Z6) (Ziemer) and four with the ONE Microkeratome (MK) (Moria). Corneal thickness was measured with ultrasound pachymetry before and after the dissection. The Stromal bed quality was evaluated using light microscopy (n = 4) and scanning electron microscopy (SEM) (n = 9). The surface roughness on SEM images was graded on the scale of 1 (smoothest) to 5 (roughest) by four observers, blinded to the method used. Particle analysis on the SEM images was performed in order to have an objective measure of smoothness. Results: The achieved dissection depth using the FS laser was 496.4 ± 46.4 µm when attempting 500 µm and 474 ± 60 µm with the microkeratome when attempting 350 µm. Histological evaluation of the corneoscleral buttons by both light and electron microscopy showed significantly smoother surface using the FS laser compared to the microkeratome. There were fewer and smaller particles observed in the SEM images of FS laser cut buttons (p < 0.001).The average observer based score of anterior surface roughness (50×) was 2.2 for the FS laser and 3.9 for the microkeratome dissections (p < 0.001). Conclusions: The LDV femtosecond laser (Z6) platform is capable of creating deep corneal lamellar dissection with smoother surface quality and with more predictable cut depth as compared to the One Microkeratome.ARTICLE HISTORY

show abstract

Surface Metrology and 3-Dimensional Confocal Profiling of Femtosecond Laser and Mechanically Dissected Ultrathin Endothelial Lamellae

Cited by 7 publications

References 41 publications

Prospective evaluation of clinical outcomes between pre‐cut corneal grafts prepared using a manual or automated technique: with one‐year follow‐up

Prospective evaluation of clinical outcomes between pre‐cut corneal grafts prepared using a manual or automated technique: with one‐year follow‐up

A Randomized Multicenter Clinical Trial of Ultrathin Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) versus DSAEK

Scanning Electronic Microscopy Evaluation of the Roughness of the Stromal Bed After Deep Corneal Cut with the LDV Femtosecond Laser (Z6) (Ziemer) and the ONE Microkeratome (Moria)

Contact Info

Product

Resources

About