Evaluating DSAEK graft deturgescence in preservation medium after microkeratome cut with optical coherence tomography

Purpose: To evaluate the Descemet stripping automated endothelial keratoplasty (DSAEK) graft deturgescence in preservation medium after microkeratome cut using Fourier domain optical coherence tomography. Methods: The central and peripheral thickness of DSAEK grafts was measured by Fourier domain optical coherence tomography immediately after microkeratome cuts and 1, 2, 3, and 4 hours afterward. All measurements were taken when the grafts were stored in 4°C preservation medium. The hourly change in central graft thickness and graft shape (peripheral graft thicknes 2 central graft thickness) was calculated and tracked over time. Results: Five DSAEK grafts were measured. The average central graft thickness was 188.7 ± 44.4 μm (range, 146-255 μm) immediately after microkeratome cuts. The average central graft thickness was 147.5 ± 33.0 μm (range, 116-190 μm) after 4 hours in preservation medium (P < 0.001). The average hourly change in central graft thickness was 230.5 mm (P = 0.0051), 28.6 mm (P = 0.055), 22.0 μm (P = 0.42), and 0.0 μm (P = 0.93) at 1, 2, 3, and 4 hours, respectively, after microkeratome cuts. The average hourly change in graft shape was insignificant. Conclusions: DSAEK grafts become thinner after microkeratome cut and stabilize at approximately 2 hours. Therefore, DSAEK graft thickness should be measured at 1.5 to 3 hours after microkeratome cut.