Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010620

Kim, Hwang, Lim, and Kim: Four Cases of Split Cornea Transplantation from a Single Cornea

Abstract

Purpose

To report four cases of split cornea transplantation involving separate Descemet membrane keratoplasty and Deep anterior lamella keratoplasty from a single cornea.

Case summary

Four donor corneas were separated into the endothelium and other layers. The endothelial layers were transplanted into 4 pseudophakic bullous keratopathy patients, and the other layers were stored in corneal storage media. Deep anterior lamella keratoplasties were performed with the stored corneas in 2 lipid keratopathy and 2 keratoconus patients. Postoperatively, all grafted corneas were stable.

Conclusions

The authors report the first 4 cases of split cornea transplantation in Korea, which is experiencing a shortage of do-nated corneas. Split cornea transplantation will be of benefit to a large number of patients by separating a single cornea into separate layers to be implanted into two patients.

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Figure 1.
Slit-lamp photographs of a Descemet membrane keratoplasty (DMEK) case. (A) Corneal opacity is seen in pseudophakic bullous keratopathy (PBK) patient before DMEK by slit lamp examination. (B) Clear graft is seen after two months following DMEK.
jkos-57-988f1.tif
Figure 2.
Slit-lamp photographs of a Deep anterior lamella keratoplasty (DALK) case. (A) Corneal opacity is seen at the center of the cornea in the keratoconus patient before DALK by slit lamp examination. (B) After one month postoperatively, clear graft but mild descemet membrane folds are to be seen in the recipient cornea. There is no rejection sign.
jkos-57-988f2.tif
Table 1.
Demographic and operative details of DMEK patients
  Data
Sex (eyes)  
 Male 2
 Female 2
Age (years)  
 Mean 53.50
 Range 53.50 ± 16.90
Preoperative UCVA (log MAR)  
 Mean 1.90
 Range 1.90 ± 0.08
Preoperative corneal endothelial density (cells/mm²) All uncheckable
Indication for surgery (eyes)  
 PBK 4

Values are presented as mean ± SD unless otherwise indicated.

DMEK = Descemet membrane keratoplasty; UCVA = uncorrected visual acuity; PBK = pseudophakic bullous keratopathy.

Table 2.
Demographic and operative details of DALK patients
  Data
Sex (eyes)  
 Male 2
 Female 2
Age (years)  
 Mean 47.25
 Range 47.25 ± 9.14
Preoperative UCVA (log MAR)  
 Mean 1.32
 Range 1.32 ± 0.50
Preoperative corneal endothelial density (cells/mm2)  
 Mean 2,777
 Range 2,777 ± 189
Indication for surgery (eyes)  
 Lipid keratopathy 2
 Keratoconus 2

Values are presented as mean ± SD unless otherwise indicated.

DALK = deep anterior lamella keratoplasty; UCVA = uncorrected visual acuity.

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