Comparison of Graft Thickness Measured by Eye Bank with Graft Thickness Measured after DSAEK

Purpose: To compare donor lenticule thickness reported by the eye bank with lenticule thickness measured at 6 months after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: This prospective, interventional case series enrolled 30 eyes from 30 patients who underwent DSAEK using precut eye bank tissue. Preoperative thickness measurements of the donor lenticules were taken centrally and at pericentral and peripheral graft areas using an anterior segment optical coherence tomography system. The same measurements were repeated 6 months postoperatively. The preoperative and postoperative values were compared, and the relationships between these measurements were investigated using Pearson correlation coefficients. Results: The mean donor age was 47.7±10.7 years old. The mean preoperative endothelial cell density was 3016.8±361.4 cells/mm2, which decreased to 1644.9±482.0 cells/mm2 postoperatively (P<0.001). The graft thickness of the precut tissue, as reported by the eye bank, was 136.8±24.9 μm at the center, 149.4±27.3 μm at the pericentral area, and 198.4±32.8 μm at the periphery. The corresponding postoperative values were 119.2±29.8 μm (P=0.004), 124.5±34.6 μm (P=0.002), and 156.3±45.4 μm (P<0.001), respectively. The graft thickness measured by the eye bank was significantly associated with that measured in vivo at 6 months at the central (r=0.63, P=0.001) and pericentral (r=0.50, P=0.009) graft area. However, the correlation between preoperative and postoperative peripheral graft thickness was insignificant (P=0.14). Conclusion: Compared to preoperative values, central, pericentral and peripheral graft thicknesses were reduced by 10.4%, 14.2%, and 18.4%, respectively, 6 months after DSAEK. Postoperative graft thinning was greater at the periphery compared with the central and pericentral area.