Skip to main content
Journal cover image

Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty.

Publication ,  Journal Article
Kuo, AN; Harvey, TM; Afshari, NA
Published in: Am J Ophthalmol
January 2008

PURPOSE: To present a novel technique to deliver the endothelial graft in small incision Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and to compare graft trauma between forceps delivery and the novel technique. DESIGN: Laboratory investigation with an interventional case report. METHODS: Ten pairs of human donor corneas were sectioned using an automated microkeratome system (Moria ALTK System, Antony, France). The recipient model was prepared by creating a 3 mm clear corneal wound in another human donor cornea. For each pair of corneas, one endothelial graft underwent single-fold delivery with forceps, while the other was delivered with the novel cartridge based technique. Each graft was stained with 0.25% trypan blue and 0.2% alizarin red, and digital photomicrographs were taken. A proportion of graft injury was calculated and differences were analyzed. Subsequently, a patient requiring DSAEK underwent the modified novel insertion technique. RESULTS: After insertion, the mean proportion of graft endothelial injury from forceps delivery through the ex vivo model was 26.02% (n = 10, standard deviation [SD] +/- 14.85%). The mean proportion of graft endothelial injury from cartridge delivery was 9.85% (n = 10, SD +/- 4.33%). The median difference between the two methods was -13%, representing less endothelial injury with the cartridge. This difference was statistically significant (P = .006). The patient who underwent DSAEK with this technique had improved visual acuity and a clear graft at five months. CONCLUSIONS: In our surgical model, inserting an endothelial graft through a small corneal wound using a novel cartridge-based technique created significantly less endothelial damage than with forceps insertion. Clinically, this technique was performed without complication.

Duke Scholars

Published In

Am J Ophthalmol

DOI

ISSN

0002-9394

Publication Date

January 2008

Volume

145

Issue

1

Start / End Page

91 / 96

Location

United States

Related Subject Headings

  • Trypan Blue
  • Tissue Donors
  • Ophthalmology & Optometry
  • Middle Aged
  • Intraoperative Complications
  • Humans
  • Female
  • Endothelium, Corneal
  • Descemet Membrane
  • Corneal Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kuo, A. N., Harvey, T. M., & Afshari, N. A. (2008). Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty. Am J Ophthalmol, 145(1), 91–96. https://doi.org/10.1016/j.ajo.2007.08.036
Kuo, Anthony N., Thomas M. Harvey, and Natalie A. Afshari. “Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty.Am J Ophthalmol 145, no. 1 (January 2008): 91–96. https://doi.org/10.1016/j.ajo.2007.08.036.
Kuo AN, Harvey TM, Afshari NA. Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2008 Jan;145(1):91–6.
Kuo, Anthony N., et al. “Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty.Am J Ophthalmol, vol. 145, no. 1, Jan. 2008, pp. 91–96. Pubmed, doi:10.1016/j.ajo.2007.08.036.
Kuo AN, Harvey TM, Afshari NA. Novel delivery method to reduce endothelial injury in descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2008 Jan;145(1):91–96.
Journal cover image

Published In

Am J Ophthalmol

DOI

ISSN

0002-9394

Publication Date

January 2008

Volume

145

Issue

1

Start / End Page

91 / 96

Location

United States

Related Subject Headings

  • Trypan Blue
  • Tissue Donors
  • Ophthalmology & Optometry
  • Middle Aged
  • Intraoperative Complications
  • Humans
  • Female
  • Endothelium, Corneal
  • Descemet Membrane
  • Corneal Transplantation