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Factors affecting DSAEK graft lenticle adhesion: an in vitro experimental study
Pravin K Vaddavalli1, Vasilios F Diakonis, Ana P Canto
1*Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and †LV Prasad Eye Institute, Hyderabad, India.
Cornea
|May 10, 2014
Summary
Higher intraocular pressure and corneal venting incisions improve Descemet stripping automated endothelial keratoplasty (DSAEK) graft adhesion. Corneal massage does not significantly impact donor lenticle adhesion to the recipient cornea.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Engineering
Background:
- Descemet stripping automated endothelial keratoplasty (DSAEK) is a surgical procedure for endothelial dysfunction.
- Optimizing donor graft adhesion is crucial for successful DSAEK outcomes.
- Factors influencing graft adhesion require further investigation.
Purpose of the Study:
- To evaluate factors affecting Descemet stripping automated endothelial keratoplasty (DSAEK) donor graft lenticle adhesion.
- To determine the impact of anterior chamber air fill pressure, duration, corneal massage, and venting incisions on graft adhesion.
Main Methods:
- An experimental setup using artificial anterior chambers with recipient corneas and donor DSAEK lenticles.
- Optical coherence tomography and imaging software to quantify interface gap (IG).
- Variations in anterior chamber air fill pressure, duration, corneal massage, and venting incisions were tested.
Main Results:
- Increased intraocular pressure (IOP) showed a trend towards decreasing interface gap, but not statistically significant.
- Complete air-fluid exchange resulted in significantly higher interface gaps compared to sustained air bubbles.
- Corneal surface massage did not facilitate graft adhesion; venting incisions significantly decreased the interface gap.
Conclusions:
- Corneal venting incisions and higher anterior chamber intraocular pressure values appear to facilitate DSAEK donor graft lenticle adhesion.
- These findings may help optimize surgical techniques for improved DSAEK graft integration.
