Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaPurpose: Descemet’s stripping automated endothelial keratoplasty(DSAEK) has replaced penetrating keratoplasty as the treatment ofchoice for corneal endothelial dysfunction. Surface quality of thedonor button plays an important role in determining the visualoutcome following DSAEK. This study measured and compared thesurface roughness of endothelial grafts dissected with a femtosecondlaser (FS) and two mechanical microkeratomes (MKs).Methods: Endothelial buttons were harvested from 18 humancorneas unsuitable for transplantation with the Intralase FS60 laser(Abbott Medical Optics, Santa Anna, Ca.; n=4) and the Moria ALTK(Moria, Antony, France; n=6) or the Gebauer SLc MKs (GebauerMedizintechnik, Neuhausen, Germany; n=8). Following dissectionthe endothelial buttons were fixed in 3.0% glutaraldehyde andexamined using a confocal profiler (Sensofar PLu 2300, Terrassa,Spain) and environmental scanning electron microscopy (ESEM)(FEI-Quanta 600; Hillsboro, OR). Linear mixed model analysis wasused to quantify the difference in surface roughness between thedifferent dissection techniques.Results: Confocal profiling was able to obtain quantitative surfaceroughness measurements and high resolution 3-dimensionalreconstructions of the central 2x1.5 mm2 area of the dissectedbuttons. ESEM evaluation allowed wide field analysis at lowermagnification which corresponded well with the 3-dimensionalconfocal reconstructions. Surface roughness of FS dissected buttons(RMS =1.89 µm) was significantly higher compared with the Moria(RMS=1.05 µm) and Gebauer MKs (RMS=0.92 µm) (p