Novel technique for DSAEK yields thin grafts

A novel technique for performing Descemet stripping automated endothelial keratoplasty (DSAEK) consistently yields thin grafts, according to recently published research in the British Journal of Ophthalmology.

The team, led by Professor Joaquim Neto Murta (Ophthalmology Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, Coimbra, Portugal), prepared 25 DSAEK grafts using a novel technique. The technique involved two sequential cuts, the first of which was of variable thickness using a femtosecond laser and the second was performed using a 300 µm microkeratome head.

To analyse the new technique the team measured spectacle corrected visual acuity and endothelial cell density (with specular microscopy and anterior segment optical coherence tomography) at the periphery and the centre of the grafts both preoperatively and at 1, 3 and 6 months postoperatively.

No irregular cuts or perforations occurred during tissue preparation and the team found that central graft thickness was 79.6 µm and 69.3 µm at 3 and 6 months respectively. Spectacle corrected distance visual acuity was found to improve from 0.91 logMAR preoperatively to 0.11 logMAR at 6 months post-op.

In conclusion, the novel technique was deemed to provide consistently thin grafts of lower than 100 µm and good visual acuity outcomes. Additionally, no graft detachments were encountered and so there was no wastage of donor tissue.