Preparation of ultrathin grafts for Descemet-stripping endothelial keratoplasty with a single microkeratome pass

We present a technique to achieve ultrathin Descemet-stripping automated endothelial keratoplasty (DSAEK). Using a simple method of controlling artificial anterior chamber pressure and drying the corneal surface, it was possible to thin the donor cornea at a rate of 11 mu m a minute. When the donor cornea was between 500 pm and 510 mu m, a single pass was made using a 350 mu m microkeratome head followed by a peripheral dissection. The resulting mean graft thickness was 83.2 mu m +/- 14.9 (SD) (range 50 to 98 gm) with a mean peripheral graft edge thickness of 106.8 +/- 10.9 mu m (range 90 to 120 mu m). There were no surgical complications, and all grafts remained attached. This is a reliable method for preparing ultrathin donor corneal lenticules for DSAEK in the operating room or eye bank without using multiple microker-atome heads or risking double passes. (C) 2016 ASCRS and ESCRS