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Donor crosslinking for keratoplasty: a laboratory evaluation

Mukherjee, Achyut, Hayes, Sally, Aslanides, Ioannis, Lanchares, Elena and Meek, Keith Michael Andrew 2015. Donor crosslinking for keratoplasty: a laboratory evaluation. Graefe's Archive for Clinical and Experimental Ophthalmology 252 (12) , pp. 2223-2228. 10.1007/s00417-015-3160-6

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Abstract

Purpose This laboratory-based investigation compares the topographic outcomes of conventional penetrating keratoplasty with that of a novel procedure in which donor corneas are cross-linked prior to keratoplasty. Methods Penetrating keratoplasty procedureswith continuous running sutures were carried out in a porcine whole globe model. Sixty eyes were randomly paired as ‘donor’ and ‘host’ tissue before being assigned to one of two groups. In the crosslinked group, donor corneas underwent riboflavin/UVA crosslinking prior to being trephined and sutured to untreated hosts. In the conventional keratoplasty group, both host and donor corneas remained untreated prior to keratoplasty. Topographic and corneal wavefront measurements were performed following surgery, and technical aspects of the procedure evaluated. Results Mean keratometric astigmatism was significantly lower in the cross-linked donor group at 3.67D (SD 1.8 D), vs. 8.43 D (SD 2.4 D) in the conventional keratoplasty group (p<0.005). Mean wavefront astigmatism was also significantly reduced in the cross-linked donor group 4.71 D (SD 2.1) vs. 8.29D (SD 3.6) in the conventional keratoplasty group (p<0.005). Mean RMS higher order aberration was significantly lower in the cross-linked donor group at 1.79 um (SD 0.98), vs. 3.05 um (SD 1.9) in the conventional keratoplasty group (P=0.02). Qualitative analysis revealed less tissue distortion at the graft-host junction in the cross-linked group. Conclusion Cross-linking of donor corneas prior to keratoplasty reduces intraoperative induced astigmatism and aberrations in an animal model. Further studies are indicated to evaluate the implications of this potential modification of keratoplasty surgery.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Optometry and Vision Sciences
Subjects: R Medicine > RE Ophthalmology
Publisher: Springer-Verlag
ISSN: 0721-832X
Funders: MRC
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 21 August 2015
Last Modified: 04 Jun 2017 08:25
URI: http://orca.cf.ac.uk/id/eprint/77895

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