A laboratory model for microkeratome-assisted posterior lamellar keratoplasty utilizing a running graft suture and a sutureless hinged flap

Li Li, Kenneth R. Ellis, Ashley Behrens, Paula M. Sweet, Roy S. Chuck

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose. To evaluate changes in anterior corneal curvature and graft stability with different sized donor buttons in a laboratory model of posterior lamellar keratoplasty. Methods. Thirty-six human eye bank corneas (18 donors and 18 recipients) were mounted on an artificial anterior chamber. A manual microkeratome was used to create a hinged anterior lamellar keratectomy. A 7.0-mm diameter posterior lamellar disk (posterior stroma, Descemet's membrane, and endothelium) was then trephinated from the recipient cornea. Three different sizes (7.0, 7.25, and 7.5 mm) of donor buttons were compared. They were sutured into the recipient bed with a running 10-0 nylon suture and covered by the host corneal flap. The flap was replaced without sutures. The resulting endokeratoplasty was analyzed by computerized videokeratography and tonometry. Results. Regular postoperative astigmatism was present in all cases. There was an average increase in astigmatism of 1.47 ± 1.49 diopters (D) postoperatively. The mean change in the average keratometry readings was -5.12 ± 6.12 D. The grafts and flaps maintained watertight seals with average leak pressures of 66.9 ± 46.4 mm Hg. Although donor buttons oversized by 0.5 mm had the least change in average keratometry reading, those oversized by 0.25 mm had the best stability at high pressure. All groups had little change in astigmatism. Conclusion. The optimal sized button of those tested would be either oversized by 0.25 or 0.5 mm. This new surgical technique may result in lower risk of high and irregular astigmatism in the management of corneal endothelial disorders.

Original languageEnglish (US)
Pages (from-to)192-195
Number of pages4
JournalCornea
Volume21
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Corneal Transplantation
Astigmatism
Running
Sutures
Transplants
Cornea
Reading
Eye Banks
Descemet Membrane
Corneal Topography
Pressure
Nylons
Manometry
Anterior Chamber
Endothelium

Keywords

  • Astigmatism
  • Corneal transplantation
  • Microkeratome
  • Posterior lamellar keratoplasty

ASJC Scopus subject areas

  • Ophthalmology

Cite this

A laboratory model for microkeratome-assisted posterior lamellar keratoplasty utilizing a running graft suture and a sutureless hinged flap. / Li, Li; Ellis, Kenneth R.; Behrens, Ashley; Sweet, Paula M.; Chuck, Roy S.

In: Cornea, Vol. 21, No. 2, 2002, p. 192-195.

Research output: Contribution to journalArticle

Li, Li ; Ellis, Kenneth R. ; Behrens, Ashley ; Sweet, Paula M. ; Chuck, Roy S. / A laboratory model for microkeratome-assisted posterior lamellar keratoplasty utilizing a running graft suture and a sutureless hinged flap. In: Cornea. 2002 ; Vol. 21, No. 2. pp. 192-195.
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abstract = "Purpose. To evaluate changes in anterior corneal curvature and graft stability with different sized donor buttons in a laboratory model of posterior lamellar keratoplasty. Methods. Thirty-six human eye bank corneas (18 donors and 18 recipients) were mounted on an artificial anterior chamber. A manual microkeratome was used to create a hinged anterior lamellar keratectomy. A 7.0-mm diameter posterior lamellar disk (posterior stroma, Descemet's membrane, and endothelium) was then trephinated from the recipient cornea. Three different sizes (7.0, 7.25, and 7.5 mm) of donor buttons were compared. They were sutured into the recipient bed with a running 10-0 nylon suture and covered by the host corneal flap. The flap was replaced without sutures. The resulting endokeratoplasty was analyzed by computerized videokeratography and tonometry. Results. Regular postoperative astigmatism was present in all cases. There was an average increase in astigmatism of 1.47 ± 1.49 diopters (D) postoperatively. The mean change in the average keratometry readings was -5.12 ± 6.12 D. The grafts and flaps maintained watertight seals with average leak pressures of 66.9 ± 46.4 mm Hg. Although donor buttons oversized by 0.5 mm had the least change in average keratometry reading, those oversized by 0.25 mm had the best stability at high pressure. All groups had little change in astigmatism. Conclusion. The optimal sized button of those tested would be either oversized by 0.25 or 0.5 mm. This new surgical technique may result in lower risk of high and irregular astigmatism in the management of corneal endothelial disorders.",
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N2 - Purpose. To evaluate changes in anterior corneal curvature and graft stability with different sized donor buttons in a laboratory model of posterior lamellar keratoplasty. Methods. Thirty-six human eye bank corneas (18 donors and 18 recipients) were mounted on an artificial anterior chamber. A manual microkeratome was used to create a hinged anterior lamellar keratectomy. A 7.0-mm diameter posterior lamellar disk (posterior stroma, Descemet's membrane, and endothelium) was then trephinated from the recipient cornea. Three different sizes (7.0, 7.25, and 7.5 mm) of donor buttons were compared. They were sutured into the recipient bed with a running 10-0 nylon suture and covered by the host corneal flap. The flap was replaced without sutures. The resulting endokeratoplasty was analyzed by computerized videokeratography and tonometry. Results. Regular postoperative astigmatism was present in all cases. There was an average increase in astigmatism of 1.47 ± 1.49 diopters (D) postoperatively. The mean change in the average keratometry readings was -5.12 ± 6.12 D. The grafts and flaps maintained watertight seals with average leak pressures of 66.9 ± 46.4 mm Hg. Although donor buttons oversized by 0.5 mm had the least change in average keratometry reading, those oversized by 0.25 mm had the best stability at high pressure. All groups had little change in astigmatism. Conclusion. The optimal sized button of those tested would be either oversized by 0.25 or 0.5 mm. This new surgical technique may result in lower risk of high and irregular astigmatism in the management of corneal endothelial disorders.

AB - Purpose. To evaluate changes in anterior corneal curvature and graft stability with different sized donor buttons in a laboratory model of posterior lamellar keratoplasty. Methods. Thirty-six human eye bank corneas (18 donors and 18 recipients) were mounted on an artificial anterior chamber. A manual microkeratome was used to create a hinged anterior lamellar keratectomy. A 7.0-mm diameter posterior lamellar disk (posterior stroma, Descemet's membrane, and endothelium) was then trephinated from the recipient cornea. Three different sizes (7.0, 7.25, and 7.5 mm) of donor buttons were compared. They were sutured into the recipient bed with a running 10-0 nylon suture and covered by the host corneal flap. The flap was replaced without sutures. The resulting endokeratoplasty was analyzed by computerized videokeratography and tonometry. Results. Regular postoperative astigmatism was present in all cases. There was an average increase in astigmatism of 1.47 ± 1.49 diopters (D) postoperatively. The mean change in the average keratometry readings was -5.12 ± 6.12 D. The grafts and flaps maintained watertight seals with average leak pressures of 66.9 ± 46.4 mm Hg. Although donor buttons oversized by 0.5 mm had the least change in average keratometry reading, those oversized by 0.25 mm had the best stability at high pressure. All groups had little change in astigmatism. Conclusion. The optimal sized button of those tested would be either oversized by 0.25 or 0.5 mm. This new surgical technique may result in lower risk of high and irregular astigmatism in the management of corneal endothelial disorders.

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