Advertisement

International Ophthalmology

, Volume 39, Issue 11, pp 2553–2559 | Cite as

Configuration of recipient corneal cut after mechanical trephination in keratoconus

  • Sepehr FeiziEmail author
  • Maryam Najafi
  • Mohammad Ali Javadi
  • Amir A. Azari
Original Paper
  • 40 Downloads

Abstract

Purpose

To determine the roundness of recipient corneal cuts after mechanical trephination and to investigate possible factors that could affect the corneal bed configuration in deep anterior lamellar keratoplasty (DALK).

Methods

This study enrolled 85 eyes with keratoconus that underwent DALK. Recipient corneas were partially trephined using a new, unused, disposable Hessburg-Barron suction trephine. Photographs that best represented the recipient corneal cut were selected, and ImageJ software was used to evaluate the roundness of recipient bed. The effect of potential variables on the roundness of cuts was investigated using the univariate analyses.

Results

The mean patient age was 31.0 ± 9.0 years. The mean recipient trephine size was 8.04 ± 0.29 mm (range 7.5–8.50 mm). The recipient cut roundness was 0.922 ± 0.070, varying from 0.78 to 1.0. The roundness of the corneoscleral limbus (0.874 ± 0.074) which represented the shape of recipient cornea was the main predictor of the configuration of recipient cut (r = 0.84, P < 0.001). Other preoperative characteristics investigated were mean keratometry (P = 0.63), keratometric astigmatism (P = 0.18), central corneal thickness (P = 0.64), keratoconus severity (P = 0.37), and trephine size (P = 0.50) that demonstrated no significant associations with the roundness of cut.

Conclusions

The recipient corneal cut after mechanical trephination may not be circular. The roundness of recipient bed was primarily affected by the roundness of corneoscleral limbus, indicating that the shape of recipient cut tends to follow the original shape of the cornea.

Keywords

Hessburg-Barron suction trephine Deep anterior lamellar keratoplasty Recipient corneal cut Roundness Mechanical trephination 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Fares U, Sarhan AR, Dua HS (2012) Management of post-keratoplasty astigmatism. J Cataract Refract Surg 38:2029–2039CrossRefGoogle Scholar
  2. 2.
    Troutman RC (1979) Astigmatism considerations in corneal graft. Ophthalmic Surg 10:21–26PubMedGoogle Scholar
  3. 3.
    Villacriz E, Smith RE (1986) Corneal recipient bed distortion due to scleral fixation rings. Cornea 5:75–79CrossRefGoogle Scholar
  4. 4.
    Van Rij G, Waring GO (1988) Configuration of corneal trephine opening using 5 different trephines in human donor eyes. Arch Ophthalmol 106:1228–1233CrossRefGoogle Scholar
  5. 5.
    Wilbanks GA, Cohen S, Chipman M et al (1996) Clinical outcomes following penetrating keratoplasty using the Barron-Hessburg and Hanna corneal trephination systems. Cornea 15:589–598PubMedGoogle Scholar
  6. 6.
    Moshirfar M, Calvo CM, Kinard KI et al (2011) Comparison of Hanna and Hessburg-Barron trephine and punch systems using histological, anterior segment optical coherence tomography, and elliptical curve fitting models. Clin Ophthalmol 5:1121–1125CrossRefGoogle Scholar
  7. 7.
    Amsler M (1946) Keratocone classique et keratocone fruste, arguments unitaires. Ophthalmologica 111:96–101CrossRefGoogle Scholar
  8. 8.
    Feizi S, Javadi MA, Jamali H et al (2010) Deep anterior lamellar keratoplasty in patients with keratoconus: big-bubble technique. Cornea 29:177–182CrossRefGoogle Scholar
  9. 9.
    Spadea L, Bianco G, Mastrofini MC et al (1996) Penetrating keratoplasty with donor and recipient corneas of the same diameter. Ophthalmic Surg Lasers 27:425–430PubMedGoogle Scholar
  10. 10.
    Courrier E, Lépine T, Hor G et al (2016) Size of the lesions of superficial punctate keratitis in dry eye syndrome observed with a slit lamp. Cornea 35:1004–1007CrossRefGoogle Scholar
  11. 11.
    Djuzenova CS, Elsner I, Katzer A et al (2013) Radiosensitivity in breast cancer assessed by the histone γ-H2AX and 53BP1 foci. Radiat Oncol 8:98CrossRefGoogle Scholar
  12. 12.
    Wiesmann V, Franz D, Held C et al (2015) Review of free software tools for image analysis of fluorescence cell micrographs. J Microsc 257:39–53CrossRefGoogle Scholar
  13. 13.
    Wu KH, Madigan MC, Billson FA et al (2003) Differential expression of GFAP in early v late AMD: a quantitative analysis. Br J Ophthalmol 87:1159–1166CrossRefGoogle Scholar
  14. 14.
    Woeffler-Maucler C, Beghin A, Ressnikoff D et al (2014) Automated immunohistochemical method to quantify neuronal density in brain sections: application to neuronal loss after status epilepticus. J Neurosci Methods 225:32–41CrossRefGoogle Scholar
  15. 15.
    Tchoukalova YD, Harteneck DA, Karwoski RA et al (2003) A quick, reliable, and automated method for fat cell sizing. J Lipid Res 44:1795–1801CrossRefGoogle Scholar
  16. 16.
    Rifkin LH, Stojadinovic S, Stewart CH et al (2012) An athymic rat model of cutaneous radiation injury designed to study human tissue-based wound therapy. Radiat Oncol 7:68CrossRefGoogle Scholar
  17. 17.
    Irving BA, Weltman JY, Brock DW et al (2007) NIH ImageJ and Slice-O-Matic computed tomography imaging software to quantify soft tissue. Obesity 15:370–376CrossRefGoogle Scholar
  18. 18.
    Feizi S, Masoudi A, Rahimi B et al (2019) Geometric properties of donor corneas after mechanical trephination in deep anterior lamellar keratoplasty. Cornea 38:35–41CrossRefGoogle Scholar
  19. 19.
    van Rij G, Cornell FM, Waring GO 3rd et al (1985) Postoperative astigmatism after central vs eccentric penetrating keratoplasties. Am J Ophthalmol 99:317–320CrossRefGoogle Scholar
  20. 20.
    Buzard KA, Fundingsland BR (1997) Corneal transplant for keratoconus: results in early and late disease. J Cataract Refract Surg 23:398–406CrossRefGoogle Scholar
  21. 21.
    Liu Y, Seitz B, Langenbucher A et al (2003) Impact of preoperative corneal curvature on the outcome of penetrating keratoplasty in keratoconus. Cornea 22:409–412CrossRefGoogle Scholar
  22. 22.
    van Buskirk EM (1989) The anatomy of the limbus. Eye 3:101–108CrossRefGoogle Scholar
  23. 23.
    Angunawela RI, Riau A, Chaurasia SS et al (2012) Manual suction versus femtosecond laser trephination for penetrating keratoplasty: intraocular pressure, endothelial cell damage, incision geometry, and wound healing responses. Invest Ophthalmol Vis Sci 53:2571–2579CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Sepehr Feizi
    • 1
    Email author
  • Maryam Najafi
    • 1
  • Mohammad Ali Javadi
    • 1
  • Amir A. Azari
    • 1
  1. 1.Ophthalmic Research Center, Labbafinejad Medical CenterShahid Beheshti University of Medical SciencesTehranIran

Personalised recommendations