Descemet-stripping automated endothelial keratoplasty donor tissue preparation using the double-pass microkeratome technique

PURPOSE: To compare human donor corneal lenticule thickness, endothelial cell viability, area of cell damage, and cell counts between corneal tissue prepared with a double-pass microkeratome cut versus the standard single-pass microkeratome cut. SETTING: University of Colorado Teaching Hospital, Aurora, Colorado, USA. DESIGN: Experimental study. METHODS: Eleven matched pairs of human donor corneas unfit for transplantation were used for analysis. Tissue was prepared using a Mona CB microkeratome and artificial anterior chamber. One cornea was prepared using the standard single-pass cut; the second cornea was prepared with a double-pass technique. Visante optical coherence tomography images were obtained from each cornea, and central and peripheral thickness measurements were made. The tissue was also stained with trypan blue and alizarin red to assess tissue damage from preparation. RESULTS: The mean central thickness measurement was 92 mu m +/- 20 (SD) for the double-pass technique and 126 +/- 34 mu m for the single-pass technique. The area of cell damage after preparation was not significantly different between the 2 methods; however, there was a statistically significant increase in the ratio of nonviable to viable cells for the double-pass technique. CONCLUSION: The double-pass microkeratome technique for donor preparation resulted in a thinner lenticule than a single-pass technique and an increase in endothelial cell damage. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. J Cataract Refract Surg 2013; 39:446-450 (C) 2013 ASCRS and ESCRS