Effects of a Novel Push-through Technique Using the Implantable Collamer Lens Injector System for Graft Delivery during Endothelial Keratoplasty.
- Author:
Sug Jae KANG
1
;
Myung Hun KIM
;
Mee Kum KIM
;
Won Ryang WEE
;
Jin Hak LEE
;
Eui Sang CHUNG
Author Information
- Publication Type:Original Article
- Keywords: Descemet's stripping endothelial keratoplasty; Endothelial viability; Visian implantable collamer lens injector system
- MeSH: Animals; Corneal Endothelial Cell Loss/*prevention & control; Descemet Stripping Endothelial Keratoplasty/*methods; Lens Implantation, Intraocular/*instrumentation/*methods; Lenses, Intraocular; Models, Animal; Postoperative Complications/*prevention & control; Prosthesis Design; Swine
- From:Korean Journal of Ophthalmology 2013;27(2):87-92
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To investigate effects of a new push-through insertion method for donor lenticules using an injector system on endothelial viability ex vivo and in a clinical case series of endothelial keratoplasty. METHODS: An ex vivo delivery model was used with porcine corneoscleral rims. We compared the endothelial viability in a new push-through insertion method using the Visian Implantable Collamer Lens (ICL) injector versus that of standard forceps-assisted insertion for lenticule delivery. Twenty porcine corneal lenticules were divided into four groups by insertion method and wound size. Vital dye staining was performed and devitalized areas were semi-quantitatively assessed by digital imaging. In the clinical case series, Descemet's stripping endothelial keratoplasty (DSEK) using the push-through method was performed in seven patients and endothelial outcome was determined six months postoperatively. RESULTS: Mean devitalized areas for the push-through method were significantly lower than for forceps-assisted insertion through 3.2 mm incision (23.99 +/- 2.17% vs. 50.48 +/- 5.07%, p = 0.009) in the ex vivo model. Average endothelial cell counts of donor tissues of patients who underwent DSEK were 26.4% lower six months postoperatively. CONCLUSIONS: Push-through delivery of donor lenticules using the Visian ICL injector system appears to be less harmful to endothelial cells than conventional forceps-assisted delivery.
