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One Cornea Can Be Split for Use in Two Patients

Last Updated: February 14, 2011.

A single donor cornea can be split and successfully transplanted into two recipients, according to a study published in the February issue of Ophthalmology.

MONDAY, Feb. 14 (HealthDay News) -- A single donor cornea can be split and successfully transplanted into two recipients, according to a study published in the February issue of Ophthalmology.

Ludwig M. Heindl, M.D., of Friedrich-Alexander University Erlangen-Nurnberg in Germany, and colleagues evaluated the feasibility of using a single donor cornea for two recipients by performing deep anterior lamellar keratoplasty (DALK) and Descemet's membrane endothelial keratoplasty (DMEK) surgeries on the same day. Twelve consecutive donor corneas were used. When a full thickness graft was not required, the cornea was split and the anterior lamella was transplanted into a patient with keratoconus. Later, the stored endothelium-Descemet's membrane layer was transplanted into a patient with Fuchs' endothelial dystrophy. Outcome measures included surgery success, best spectacle-corrected visual acuity (BSCVA), and complication rates within six months.

The researchers successfully used a single cornea for two recipients in 10 of the 12 donor corneas, but two corneas could not be split when DALK procedures were converted to penetrating keratoplasties. Six months after surgery, average BSCVA was 20/35 in 10 eyes that underwent successful DALK, 20/50 in two eyes that underwent conversion from DALK to penetrating keratoplasty, and 20/31 in 10 eyes that underwent DMEK. Complications included Descemet's folds and epitheliopathy after DALK, and partial graft detachment after DMEK. All corneas remained clear up to six months after surgery.

"Split cornea transplantation requires advanced corneal surgical techniques and sophisticated patient logistics, but in the future may become a standard approach to save corneal tissue and to reduce transplantation cost," the authors write.

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