INVITED LECTURE: MASSIMO BUSIN, ITALY: ULTRATHIN DSAEK –THE PRESENT STATUSChairman, Department of Ophthalmology at “Villa Serena-Villa Igea” Hospitals in ForlìProfessor, University Eye Hospital in Bon (Germany)President, SITraC (Società Italiana Trapianto di Cornea)Biography: Massimo Busin obtained his MD degree from the Universityof Ferrara (Italy) in 1980 and trained at the Ferrara Eye Hospital to becomean ophthalmologist in June 1984. Between July 1984 and June 1986 hewas fellow in “cornea and external diseases” with Herbert E. Kaufman at the LSU Eye Center in NewOrleans (USA). He was a consultant at the University of Orange Free State in Bloemfontein (Rep. ofSouth Africa) from July 1986 till December 1986. Since January 1987 he joined the Faculty of theUniversity Eye Hospital in Bon (Germany), where he became Privat Dozent in 1989 and UniversityProfessor in 2001. Before moving back to Italy in 2006, he was granted the apl (ausserplanmaessiger)Professorship, which he still holds. Since January 1996 Professor Busin is the chairman of theDepartment of Ophthalmology at “Villa Serena-Villa Igea” Hospitals in Forlì (ITALY). Professor Businis author of 106 peer reviewed articles, 21 chapters in books, as well as 1 book. He has beenAssociate Editor for Europe of the Refractive & Corneal Surgery (now Journal of Refractive Surgery)till 1997 and presently serves regularly as reviewer for all major ophthalmologic Journals, includingOphthalmology, AJO, Archives of Ophthalmology, JCRS, etc. Since 1984, Professor Busin has deliveredover 400 lectures as invited speaker at all major meetings in the world, including AAO, DOG (DeutscheOphthalmologische Gesellschaft), ASCRS (American Society of Cataract and Refractive Surgeons),ESCRS (European Society cataract and Refractive Surgeons), DOC (Deutsche OphthalmologischeChirurgen), SOI (Società Oftalmologica Italiana), SFO (Société Français d’Ophtalmologie), etc. He hasreceived the “Honor Award” of the AAO (American Academy of Ophthalmology) in 1993 and the“Senior Honor Achievemt” award of the AAO in 2003, the Gold Medal “Maestro dell’Oftalmologia” ofSOI in 2012, and will deliver the Chancellor’s Award Lecture in Neurosciences and Ophthalmology inJanuary 2013 at the LSU Eye Center in New Orleans (USA). He has also received several prizes for bothvideos and lectures delivered at international meetings, among which the AAO, the ESCRS, the DOC,the ASCRS, etc. Professor Busin is presently President of SITraC (Società Italiana Trapianto di Cornea)Summary: Ultrathin DSAEK: The Present StatusThe lecture will present a complete review of Descemet Stripping Automated Endothelial Keratoplasty(DSAEK), focussing in particular on the development of the technique for the dissection of ultrathin(UT) donor tissue. History as well as basic principles necessary to understand the mechanisms of UTDSAEK will be introduced to the attendees. In setting the indication to UT DSAEK, the author willdiscuss the role of recipient corneal status, type of endothelial disease, concomitant eye disease(i.e. glaucoma), presence of clear lens and other preoperative factors. The different techniques ofconventional DSAEK, UT DSAEK and Descemet membrane endothelial keratoplasty (DMEK) willbe compared, pointing out the single steps, which are instrumental in facilitating surgery, whileimproving the final outcome. In case of multiple intervention, combined versus sequential procedures(e.g. phacoemulsification, IOL surgery, vitrectomy, etc.) will be discussed. The authors will highlightadvantages and disadvantages of different surgical approaches. Possible implications for eye bankingwill also be addressed, with particular emphasis on preparation and storage of tissue for UT DSAEKand DMEK. Slides and videos of case studies will illustrate the most common complications (i.e. graftdetachment, dislocation, failure, rejection etc.) as well as the appropriate solutions.36
PRECUTTING OF DONOR CORNEAS FOR POSTERIOR LAMELLAR KERATOPLASTYA. Ivarsen, S. Kerathanathan, K. Nielsen, J. HjortdalThe Danish Eye Bank, Department of Ophthalmology, Aarhus University Hospital, DenmarkPurpose: An increasing number of Eye banks offer precut corneas for posterior lamellar keratoplasty.At present there are no published studies on the outcome of DSAEK with precut organ-cultured tissue.This study compares surgeons-cut versus precut grafts.Methods: In the Danish Eye-bank, precutting is performed with the Horizon DSAEK system. Corneasare de-swollen for 24-hours in transport medium, and the appropriate single-use cutting head ischosen from ultrasound pachymetry. After cutting, the cap is replaced and the cornea is distributedfor use. Thirty-six grafts from the first six months of precutting were compared with 31 grafts fromthe last six months of surgeons-cut tissue using the Moria ALTK with a 350 head. Pentacam data wasused to determine central and peripheral thickness of the lamellar graft and the endothelial count wasdetermined using specular microscopy.Results: Average follow-up was 338 ± 37 days and 214 ± 63 days for surgeons-cut and precut grafts,respectively. No difference in preoperative and postoperative endothelial cell count was observed.Average central thickness of the graft was similar in both groups, being 164 ± 52 µm for surgeons cutand 179 ± 47 µm for precut tissue, respectively. Peripheral thickness also was similar in both groups.There was no significant difference between surgeons cut and precut grafts with respect to cuttingfailures (2 versus 4), rebubbling rate (1 versus 2) or primary failures (1 versus 1).Conclusions: Precut, organ cultured donor corneas for posterior lamellar keratoplasty appear to becomparable to corneas cut in the operating theatre.XXV ANNUAL MEETING OF THE EUROPEAN EYE BANK ASSOCIATION Zagreb, Croatia 18/19 January 2013 37
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