Systems and methods for preparing corneal tissue for implant
A technique can consistently achieve thicknesses of ≤50 μm for corneal tissue for Descemet stripping automated endothelial keratoplasty (DSAEK). Grafts with thicknesses of ≤50 μm are also known as nanothin DSAEK (NT-DSAEK) grafts. Evidence shows that using thinner DSAEK grafts, particularly NT-DSAEK grafts, can significantly improve visual outcomes. According to an example embodiment, a method for producing a corneal graft includes drying a donor cornea to cause a pre-cut thickness of the donor cornea to decrease. The method includes, concurrently with drying the donor cornea, determining pre-cut thickness measurements for the donor cornea. The method includes, in response to the pre-cut thickness measurements indicating the pre-cut thickness of the donor cornea has decreased to a predetermined value, cutting the donor cornea to a post-cut thickness of ≤100 μm, or more particularly ≤50 μm, to produce a corneal graft.
1. A method for producing a corneal graft, comprising:
using an operator-specific nomogram to determine a predicted cut depth for a donor cornea;
determining a predetermined value based on a difference between the predicted cut depth and a desired cut depth;
drying the donor cornea to cause a pre-cut thickness of the donor cornea to decrease;
concurrently with drying the donor cornea, determining pre-cut thickness measurements for the donor cornea; and
in response to the pre-cut thickness measurements indicating the pre-cut thickness of the donor cornea has decreased by the predetermined value, cutting the donor cornea to a post-cut thickness of less than or equal to 100 μm to produce the corneal graft,
wherein the donor cornea is cut with a single-pass rotational style microkeratome with a selected microkeratome head,
wherein the operator-specific nomogram uses data to generate the predicted cut depth, the data including a plurality of donor cornea cuts by an operator technician using the selected microkeratome head, wherein the data for each of the plurality of donor cornea cuts of the donor cornea includes a pre-cut thickness measurement taken immediately before cutting and a post-cut thickness measurement of the corneal graft,
wherein the operator-specific nomogram generates the predicted cut depth based on an average of the cut depths for the plurality of donor cornea cuts, wherein a cut depth for each of the plurality of donor cornea cuts is the difference between the pre-cut thickness measurement of the donor cornea and the post-cut thickness measurement.
2. The method of claim 1 , further comprising selecting the selected microkeratome head according to the predetermined value.
3. The method of claim 1 , further comprising determining the predetermined value for the decrease in the pre-cut thickness according to the selected microkeratome head.
4. The method of claim 1 , further comprising selecting the selected microkeratome head from a plurality of different microkeratome heads.
5. The method of claim 1 , wherein the post-cut thickness is less than or equal to 50 μm.
6. The method of claim 1 , wherein the pre-cut thickness measurements are determined with a pachymeter.
7. The method of claim 1 , further comprising removing an epithelium of the donor cornea to reduce the pre-cut thickness of the donor cornea further.
8. The method of claim 1 , further comprising determining a post-cut thickness measurement of the corneal graft.
9. The method of claim 1 , further comprising implanting the corneal graft according to Descemet stripping automated endothelial keratoplasty (DSAEK).
10. The method of claim 1 , further comprising drying the donor cornea to cause the post-cut thickness of the donor cornea to decrease.
11. The method of claim 1 , further comprising controlling one or more cutting variables during the cutting of the donor cornea to address the difference between the predicted cut depth and the desired cut depth.
12. The method of claim 1 , further comprising using the operator-specific nomogram to determine an amount of desired drying and decrease in the pre-cut thickness of the donor cornea.
13. The method of claim 1 , wherein the operator-specific nomogram generates a predicted graft thickness, wherein the predicted graft thickness is the difference between the pre-cut thickness measurement and the average of the cut depths.
14. The method of claim 1 , wherein the operator-specific nomogram continuously updates the data after each corneal graft is produced.