Bae Steven S, Menninga Isaac, Hoshino Richard, Humphreys Christine, Chan Clara C
Queen's University School of Medicine, Kingston, ON, Canada.
Quest University Canada, Squamish, BC, Canada.
Cornea. 2018 Jun;37(6):687-690. doi: 10.1097/ICO.0000000000001524.
The purpose of this study was to develop a nomogram to predict postcut thickness of corneal grafts prepared at an eye bank for Descemet stripping automated endothelial keratoplasty (DSAEK).
Retrospective chart review was performed of DSAEK graft preparations by 3 experienced technicians from April 2012 to May 2017 at the Eye Bank of Canada-Ontario Division. Variables collected included the following: donor demographics, death-to-preservation time, death-to-processing time, precut tissue thickness, postcut tissue thickness, microkeratome head size, endothelial cell count, cut technician, and rate of perforation. Linear regression models were generated for each microkeratome head size (300 and 350 μm).
A total of 780 grafts were processed during the study period. Twelve preparation attempts resulted in perforation (1.5%) and were excluded. Mean precut tissue thickness was 510 ± 49 μm (range: 363-670 μm). Mean postcut tissue thickness was 114 ± 22 μm (range: 57-193 μm). Seventy-nine percent (608/768) of grafts were ≤130 μm. The linear regression models included precut thickness and donor age, which were able to predict the thickness to within 25 μm 80% of the time.
We report a nomogram to predict thickness of DSAEK corneal grafts prepared in an eye bank setting, which was accurate to within 25 μm 80% of the time. Other eye banks could consider performing similar analyses.
本研究旨在开发一种列线图，以预测在眼库中为角膜后弹力层剥除自动内皮角膜移植术（DSAEK）制备的角膜移植片的术后厚度。
对2012年4月至2017年5月期间加拿大眼库安大略分部的3名经验丰富的技术人员进行的DSAEK移植片制备进行回顾性图表审查。收集的变量包括：供体人口统计学资料、死亡至保存时间、死亡至处理时间、预切组织厚度、术后组织厚度、微型角膜刀头尺寸、内皮细胞计数、切割技术人员和穿孔率。针对每种微型角膜刀头尺寸（300和350μm）生成线性回归模型。
在研究期间共处理了780片移植片。12次制备尝试导致穿孔（1.5%），被排除在外。平均预切组织厚度为510±49μm（范围：363 - 670μm）。平均术后组织厚度为114±22μm（范围：57 - 193μm）。79%（608/768）的移植片厚度≤130μm。线性回归模型包括预切厚度和供体年龄，能够在80%的时间内将厚度预测在25μm以内。
我们报告了一种列线图，用于预测在眼库环境中制备的DSAEK角膜移植片的厚度，其在80%的时间内准确到25μm以内。其他眼库可考虑进行类似分析。
