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Remote Manipulation of Posterior Lamellar Corneal Grafts Using a Magnetic Field

Nahum, Yoav MD; Barliya, Tilda PhD; Bahar, Irit MD; Livnat, Tami PhD; Nisgav, Yael MSc; Weinberger, Dov MD

doi: 10.1097/ICO.0b013e31828989a1
Basic Investigation

Purpose: In posterior lamellar keratoplasty procedures such as Descemet stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty, the lamellar graft is manipulated directly or by injecting an air bubble. This preliminary study sought to evaluate the feasibility of guiding lamellar corneal grafts by generating a magnetic field.

Methods: Rabbit and porcine Descemet stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty grafts were manually produced and immersed in a ferromagnetic solution containing nanomagnetic particles conjugated to streptavidin or in gadoteric acid. For the feasibility study, grafts were transferred to an artificial anterior chamber or plastic test tube and a magnetic field was generated with a handheld NdFeB disc magnet. The presence and the sustainability of graft motion were documented under various conditions. For the semiquantitative study, whole or partial grafts were transferred to a plastic test tube after immersion, and the amount of tissue retraction induced by the remote magnet was graded.

Results: The grafts were successfully manipulated in all directions by the magnet, from a distance of up to 7 mm. They remained ferromagnetic more than 24 hours after immersion in the ferromagnetic solutions. The degree of retraction was affected by graft size, immersion time, time from immersion, and immersion solution.

Conclusions: Posterior lamellar corneal grafts may be made ferromagnetic and remotely manipulated by creation of a magnetic field. The ferromagnetic properties are adjustable. This technique holds promise in attaching and repositioning grafts during keratoplasty. Further research is needed to assess the possible effects of ferromagnetic solutions on corneal endothelial cells and on lamellar graft clarity.

Supplemental Digital Content is Available in the Text.

Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel; Laboratory of Eye Research, Felsenstein Medical Research Center, Petah Tikva, Israel; and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Reprints: Yoav Nahum, Department of Ophthalmology, Rabin Medical Center, 39 Jabotinsky st., Petah Tikva 49100, Israel (e-mail:

Supported by a grant from the Rabin Medical Center.

A patent application relevant to this study was filed by Y. Nahum. The remaining authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received November 20, 2012

Accepted January 23, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.