*Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and †LV Prasad Eye Institute, Hyderabad, India.
Cornea. 2014 Jun;33(6):551-4. doi: 10.1097/ICO.0000000000000125.
The aim of this study was to evaluate different factors that affect Descemet stripping automated endothelial keratoplasty (DSAEK) donor graft lenticle adhesion to the recipient cornea.
This experimental study included 10 eye bank recipient corneas and 10 donor DSAEK lenticles. Recipient corneas were mounted on an artificial anterior chamber (AC), whereas donor lenticles were placed beneath the host cornea. Using optical coherence tomography and imaging software, the interface gap (IG) between the donor and recipient cornea was quantified to evaluate the effect of variations in AC air fill pressure, AC air fill duration, corneal massage, and corneal venting incisions on DSAEK donor graft lenticle adhesion.
Different intraocular pressures (IOP) under air for the same time intervals, do not significantly correlate with the IG; nevertheless, it was noticed that the IG decreases as the IOP increases. With respect to the magnitude of AC IOP, there was no statistically significant difference when comparing 10 mm Hg with 30 mm Hg and assessing IG (P = 0.4). Complete air-fluid exchange resulted in significantly higher IG when compared with AC air bubble of 10 and 30 mm Hg that was sustained for 1 hour (P < 0.05). Furthermore, corneal surface massage did not facilitate DSAEK graft adhesion (P = 0.59). Finally, paracentral venting incisions followed by interface fluid aspiration seemed to significantly decrease the IG (P = 0.014).
Corneal venting incisions and higher AC IOP values seem to facilitate DSAEK donor graft lenticle adhesion to the recipient cornea.
本研究旨在评估影响 Descemet 撕囊自动化内皮角膜移植术（DSAEK）供体移植物层粘连到受体角膜的不同因素。
本实验研究包括 10 个眼库受体角膜和 10 个供体 DSAEK 移植物。将受体角膜安装在人工前房（AC）上，而将供体移植物放置在宿主角膜下方。使用光相干断层扫描和成像软件，量化供体和受体角膜之间的界面间隙（IG），以评估 AC 空气填充压力、AC 空气填充持续时间、角膜按摩和角膜通气切口的变化对 DSAEK 供体移植物层粘连的影响。
相同时间间隔下不同的眼内压（IOP）与 IG 没有显著相关性；然而，IG 随 IOP 增加而减小。对于 AC IOP 的幅度，当比较 10mmHg 与 30mmHg 并评估 IG 时，没有统计学上的显著差异（P = 0.4）。与 AC 空气泡为 10mmHg 和 30mmHg 持续 1 小时相比，完全空气-液体交换导致 IG 显著升高（P < 0.05）。此外，角膜表面按摩并没有促进 DSAEK 移植物的附着（P = 0.59）。最后，旁中央通气切口后进行界面液抽吸似乎显著降低了 IG（P = 0.014）。
角膜通气切口和更高的 AC IOP 值似乎有助于 DSAEK 供体移植物层粘连到受体角膜。
