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Th17 and regulatory T cells are increased in blood of patients with birdshot chorioretinopathy

consecutive eyes of five patients (mean age: 60 9.34 years; three males) with corneal endothelial decompensation and complex anatomic anterior segment disorders (Table S1) in which UT-DSAEK using the SLc Expert Microkeratome was performed between March and July 2015 were analysed retrospectively. Targeted central thickness of the resulting donor lamella was defined before preparation ranging from 50 to 80 lm. Central and peripheral corneal thickness (3 mm from centre) was determined by AS-OCTmeasurements along four meridians before and directly after preparation. Deviations from the targeted central graft thickness as well as differences between peripheral and central graft thickness were calculated. Obtained differences from eight peripheral measuring points to central thickness measurements were divided into two groups (0–135° and 180–315°) to investigate uniformity in thickness relative to cut direction. Clinical outcome parameters included best spectacle-corrected visual acuity (BSCVA; logMAR), endothelial cell density (ECD; Tomey EM-3000, Erlangen, Germany), central corneal thickness (CCT) and graft thickness measured by AS-OCT (SPECTRALIS Anterior Segment Module, SpectralDomain OCT, Heidelberg Engineering GmbH, Heidelberg, Germany) before surgery as well as 1 and 3 months postoperatively. All five donor preparations were successfully performed. Deviations from the central targeted thickness were below 19.5 lm at any time (Table S1). The difference between peripheral and central graft thickness averaged along eight meridians was 44.1 16.7 lm regardless of the cutting direction. In two eyes, partial graft detachment necessitated a second intracameral air injection; no further complications occurred. MeanpreoperativeBSCVAimproved from 1.56 0.67 logMAR to 0.92 0.79 logMAR at 3 months. Endothelial cell density (ECD) of donor buttons was 2804 228.3 cells/mm2 preoperatively and 1489.8 336.3 cells/mm2 at 3 months (Table S1). Central corneal thickness (CCT) was 815.7 222.2 lm preoperatively and 562.8 99.0 lm postoperatively with a hosts’ corneal thickness without the donor lamella of 527.9 82.5 lm. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) grafts prepared using microkeratomes are typically thinner centrally than peripherally, resulting in a hyperopic shift (Dupps et al. 2008; Scorcia et al. 2009). Our results showed comparatively uniformity in graft thickness which may suggest that the uniform profile of UT-DSAEK grafts prepared by the SLc Expert microkeratome may have less impact on sphere and aberrations than ‘standard’ DSAEK grafts (Rudolph et al. 2012). Our case series is limited by the small sample size; however, we can conclude that graft preparation with the SLc Expert Microkeratome , and the subsequent transplantation of these very thin grafts even in eyeswith complex anterior segment pathologies seems to be safe and reproducible. Further clinical studies are desirable to evaluate the practicability and the clinical results of this novel technique particular in relation to DMEK.