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Updated: Mar 21, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Graft-Recipient Collagen Lamellar Axis Discrepancy Is Compatible With Excellent Visual Acuity After Descemet
Yoav Nahum1, Alfonso Iovieno, Eugenio Lipari
1*Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Department of Ophthalmology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy; §Phronema srl, Taranto, Italy; ¶Department of Ophthalmology, "Villa Igea" Hospital, Forlì, Italy; and ‖Istituto internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
Purpose:
To evaluate whether a discrepancy between the orientation of graft and recipient collagen lamellae can significantly limit the visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK).
Methods:
A multicenter cohort study of eyes that underwent DSAEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy at Villa Serena-Villa Igea private Hospitals (Forlì, Italy) and at Santa Maria Nuova public hospital (Reggio Emilia, Italy), which were scheduled for a postoperative examination between July and September 2014. We have included eyes with a distance-corrected visual acuity of 8/10 or better, no ocular comorbidities, and a clear cornea. The main outcome measure was graft-recipient axis discrepancy of lamellar orientation around the visual axis as assessed by polarimetric interferometry.
Results:
Twelve eyes were included in this study. Eight eyes had a spectacle-corrected distance visual acuity of 8/10, 3 eyes had 9/10, and 1 eye had 10/10. In 8/12 (66.7%) eyes, 2 discernible axes of collagen lamellar orientation were identified and were all 30 degrees or more apart (range 30-90). In 2 eyes, only 1 axis was identified and in another 2 eyes, 2 axes 20 and 17 degrees apart were identified. The eye with 10/10 visual acuity presented a discrepancy of 17 degrees between lamellar axes.
Conclusions:
A discrepancy between the lamellar orientation of the graft and the recipient is compatible with excellent visual acuity after DSAEK.
