Comparison of endothelial cell loss and complications following DMEK with the use of three different graft injectors.

Details

Serval ID
serval:BIB_99A55F488D73
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of endothelial cell loss and complications following DMEK with the use of three different graft injectors.
Journal
Eye
Author(s)
Droutsas K., Lazaridis A., Kymionis G.D., Chatzistefanou K., Moschos M.M., Koutsandrea C., Sekundo W.
ISSN
1476-5454 (Electronic)
ISSN-L
0950-222X
Publication state
Published
Issued date
01/2018
Peer-reviewed
Oui
Volume
32
Number
1
Pages
19-25
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
PurposeTo compare endothelial cell loss and complications following Descemet membrane endothelial keratoplasty (DMEK) with use of three commercially available injectors.MethodsFrom 179 consecutive DMEK procedures, 66 cases with uncomplicated graft preparation and completed 12-month follow-up were included in this retrospective study. According to the injector used, 3 groups were formed: group 1 (D.O.R.C. injector, n=16), group 2 (Geuder injector, n=24), and group 3 (Pasteur laboratory pipette, n= 26). Endothelial cell density (ECD) and endothelial cell loss were evaluated preoperatively and at 3, 6 and 12 months postoperatively; surgery-related complications were recorded.ResultsDonor ECD was 2416±179 cells/mm <sup>2</sup> (group 1), 2417±164 cells/mm <sup>2</sup> (group 2), and 2478±234 cells/mm <sup>2</sup> (group 3). At 12 months postoperatively ECD was 1473±403 cells/mm <sup>2</sup> (group 1), 1379±317 cells/mm <sup>2</sup> (group 2), and 1316±456 cells/mm <sup>2</sup> (group 3) (P=0.533, ANOVA). Endothelial cell loss 12 months postoperatively was 39±15% (group 1), 43±13% (group 2), and 47±17% (group 3) (P=0.386, ANOVA). A single case of iris bleeding and reflux of the graft out of the anterior chamber (both in group 3) was noted. Partial graft detachment occurred in group 1 (n=1), group 2 (n=5), and group 3 (n=7) and rebubbling was performed in 6% (group 1), 17% (group 2), and 27% (group 3).ConclusionsTo our knowledge, this is the first clinical study assessing the safety of three different DMEK injectors. Group 1 (D.O.R.C injector) showed the least and group 3 (Pasteur laboratory pipette) the highest endothelial cell loss without reaching statistical significance at 12 months after surgery. Therefore, the graft injector may be chosen according to surgeon's preference.
Keywords
Aged, Cell Count, Corneal Endothelial Cell Loss/etiology, Corneal Endothelial Cell Loss/pathology, Corneal Pachymetry, Descemet Stripping Endothelial Keratoplasty/adverse effects, Descemet Stripping Endothelial Keratoplasty/instrumentation, Endothelium, Corneal/transplantation, Equipment Design, Female, Follow-Up Studies, Fuchs' Endothelial Dystrophy/surgery, Humans, Injections/instrumentation, Male, Postoperative Complications, Retrospective Studies, Time Factors, Visual Acuity
Pubmed
Web of science
Create date
23/11/2017 21:01
Last modification date
20/08/2019 15:01
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