ESCRS - FPT06.12 - Influence Of The Microkeratome Head Size On Dsaek Thickness.

Influence Of The Microkeratome Head Size On Dsaek Thickness.

Published 2022 - 40th Congress of the ESCRS

Reference: FPT06.12 | Type: Free paper | DOI: 10.82333/t7ed-a825

Authors: Álvaro Sánchez-Ventosa* 1 , Antonio Cano-Ortiz 1 , Elisa Palacin 1 , Dolores Lopez 1 , Alberto Villarrubia 1

1Hospital La Arruzafa,Córdoba,Spain

Purpose

To analyze the influence of Moria microkeratome heads in the process of obtaining the lenticule for DSAEK. To study the reproducibility of Heidelberg optical coherence tomography in these measurements.

Setting

Hospital la Arruzafa, Córdoba (Spain)

Methods

Prospective study involving 13 cuts performed with the Moria Evolution3E microkeratome using head sizes of 350,400,450 and 500μm to obtain a lenticule for DSAEK.Donor tissue was mounted at 70mmHg.The corneal epithelium was removed to avoid irregularities.The central corneal thickness was measured with a DGH550 handheld pachymeter.A microkeratome head was selected based on the thickness of the precut tissue being 150μm lower than the thickness of the donor cornea.The following day,3 readings was taken of the central corneal thickness with the optical coherence tomograph.Likewise,3 measurements of the distance from the blade to the microkeratome stage were made using the same tomograph.All measurements were performed by the same user.

Results

The next day lenticule measurements by groups were 84.67±16.62μm, 151.50±19.56μm, 206.50±13.44μm and 266±70.71μm for the groups in which the 500, 450, 400 and 350μm head were used, respectively.

In relation to the measurements of the heads we obtained 481.89± 29.03 μm for the 500μm head, 435.94±11.05μm for the 450μm head, 379.50± 9.67μm for the 400μm head and 345.33± 9.93μm for the 350μm head.

The difference between the measurement indicated by the head manufacturer and that measured by optical coherence tomography is 14.56 ± 16.92μm, with the maximum difference being 40.52μm and the minimum 19.67μm. 

There is a direct relationship between lenticule thickness and the microkeratome head used (p<0.05) at 95% confidence.

Conclusions

Microkeratome heads are a variable to take into account in the final cutting result for DSAEK.

Thinner lenticules are achieved at higher corneal thicknesses than at lower corneal thicknesses using our nomogram. This could guide us to further adjust the nomogram at lower pachymetries.