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Clinical evaluation of a newly developed graft inserter (NS Endo-Inserter) for Descemet stripping automated endothelial keratoplasty
Authors Soma T, Koh S, Oie Y, Maruyama K, Tsujikawa M, Kawasaki S, Maeda N, Nishida K
Received 4 August 2018
Accepted for publication 6 December 2018
Published 21 December 2018 Volume 2019:13 Pages 43—48
DOI https://doi.org/10.2147/OPTH.S182628
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Takeshi Soma,1 Shizuka Koh,1,2 Yoshinori Oie,1 Kazuichi Maruyama,1,2 Motokazu Tsujikawa,1 Satoshi Kawasaki,1 Naoyuki Maeda,1 Kohji Nishida1
1Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; 2Department of Innovative Visual Science, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
Purpose: The aim of this study was to describe the postoperative outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) performed using our newly developed graft inserter (NS Endo-Inserter) and compare the findings with those for DSAEK performed using the Busin glide.
Patients and methods: In this retrospective, case-control, institutional study, we studied the clinical outcomes of DSAEK performed using the NS Endo-Inserter (NS group, n=13) or the Busin glide (Busin group, n=10) for patients with corneal endothelial dysfunction. Clinical parameters, including the distance-corrected visual acuity (DCVA), endothelial cell (EC) loss, and intraoperative/postoperative complications, were assessed over a 6-month follow-up period.
Results: At 6 months after surgery, the mean DCVA showed no significant difference between the two groups. EC loss at 3 and 6 months after DSAEK was 9.1%±20.7% and 18.2%±22.6%, respectively, in the NS group and 44.0%±25.5% and 46.5%±23.3%, respectively, in the Busin group; differences between groups were statistically significant at both 3 and 6 months (P=0.024 and P=0.016, respectively). Anterior chamber hemorrhage was observed in one patient in the Busin group. Rebubbling after surgery was required for one eye in the Busin group. No complications were observed in the NS group.
Conclusion: Our newly developed graft inserter for DSAEK may cause significantly less EC damage than the conventional pull-through technique using the Busin glide. Our inserter permits safe endothelial graft delivery without anterior chamber collapse and can result in successful graft attachment without complications at 6 months after surgery.
Keywords: corneal endothelial transplantation, clinical evaluation of new technique, endothelial cell damage, graft attachment, safety
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