Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive

Ashkan Pirouzmanesh, Samantha Herretes, Johann M G Reyes, Olan Suwan-apichon, Roy S. Chuck, Dong An Wang, Jennifer H. Elisseeff, Walter J. Stark, Ashley Behrens

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To compare graft stability and astigmatic change using suture vs tissue adhesive in an experimental model of microkeratome-assisted posterior lamellar keratoplasty. Methods: A 300-μm-thick partial flap keratectomy was performed in human donor corneoscleral rims using an artificial anterior chamber and a manual microkeratome. The flap stopped at the left central opening border, providing a wide hinge to add stability. After flap reflection, a 6.25-mm trephination was performed to obtain a disc of posterior stroma, Descemet membrane, and endothelium. The disc was positioned in a sutureless fashion, and the flap secured with either 5 interrupted sutures or a chondroitin-sulfate-aldehyde-based adhesive. Increasing intrachamber pressures were created to detect graft stability. Videokeratographic data were recorded to evaluate astigmatic change. Results: The mean (SD) astigmatic change was 3.08 (0.84) diopters (D) in the sutured group and 1.13 (0.55) D in the glued group (P = .008). Mean (SD) resisted pressures were 95.68 (27.38) mm Hg and 82.45 (18.40) mm Hg in the sutured and glued groups, respectively (P = .97). Conclusion: This modified technique of microkeratome-assisted posterior lamellar keratoplasty showed excellent graft stability in both groups. Flaps sealed with the novel tissue adhesive had reduced astigmatic changes in our experimental model. Clinical Relevance: Sutureless microkeratome-assisted posterior lamellar keratoplasty using tissue adhesive may become a new alternative in the surgical treatment of corneal endothelial disorders.

Original languageEnglish (US)
Pages (from-to)210-214
Number of pages5
JournalArchives of Ophthalmology
Volume124
Issue number2
DOIs
StatePublished - Feb 2006
Externally publishedYes

Fingerprint

Tissue Adhesives
Corneal Transplantation
Transplants
Sutures
trichostatin A
Theoretical Models
Trephining
Descemet Membrane
Pressure
Chondroitin Sulfates
Anterior Chamber
Aldehydes
Adhesives
Endothelium
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Pirouzmanesh, A., Herretes, S., Reyes, J. M. G., Suwan-apichon, O., Chuck, R. S., Wang, D. A., ... Behrens, A. (2006). Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive. Archives of Ophthalmology, 124(2), 210-214. https://doi.org/10.1001/archopht.124.2.210

Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive. / Pirouzmanesh, Ashkan; Herretes, Samantha; Reyes, Johann M G; Suwan-apichon, Olan; Chuck, Roy S.; Wang, Dong An; Elisseeff, Jennifer H.; Stark, Walter J.; Behrens, Ashley.

In: Archives of Ophthalmology, Vol. 124, No. 2, 02.2006, p. 210-214.

Research output: Contribution to journalArticle

Pirouzmanesh, A, Herretes, S, Reyes, JMG, Suwan-apichon, O, Chuck, RS, Wang, DA, Elisseeff, JH, Stark, WJ & Behrens, A 2006, 'Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive', Archives of Ophthalmology, vol. 124, no. 2, pp. 210-214. https://doi.org/10.1001/archopht.124.2.210
Pirouzmanesh, Ashkan ; Herretes, Samantha ; Reyes, Johann M G ; Suwan-apichon, Olan ; Chuck, Roy S. ; Wang, Dong An ; Elisseeff, Jennifer H. ; Stark, Walter J. ; Behrens, Ashley. / Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive. In: Archives of Ophthalmology. 2006 ; Vol. 124, No. 2. pp. 210-214.
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AU - Elisseeff, Jennifer H.

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