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Outcomes of descemet membrane endothelial keratoplasty using a pull-through technique with novel infusion forceps (DescePro)

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First Author: S.Jabbour USA

Co Author(s):    A. Jun   F. Woreta   T. Krick   D. Srikumaran           

Abstract Details

Purpose:

To describe and evaluate the early outcomes of Descemet membrane endothelial keratoplasty (DMEK) using a novel infusion forceps (DescePro) to deliver a tri-folded tissue endothelium-in with a pull-through technique by novice DMEK surgeons.

Setting:

The Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA

Methods:

Retrospective, noncomparative, interventional case series of 20 eyes with a diagnosis of Fuchs dystrophy that underwent DMEK with or without cataract surgery by surgeons early in the DMEK learning curve (less than 50 cases performed). Surgical time, best-corrected visual acuity (BCVA) at 3 and 6 months, central corneal thickness (CCT) and endothelial cell loss (ECL) at 6 months, intraoperative and postoperative complications and rebubble rates were collected. A Wilcoxon rank-sum test was applied to assess differences in outcomes at different follow-ups. P<0.05 was considered statistically significant.

Results:

Mean patient age was 63.5 ± 5.4 years. Average surgical time for solo procedures was 46 ±2 min and for combined procedures was 71 ± 12 min. BCVA improved from 0.35 ± 0.04 logMAR to 0.10 ± 0.60 logMAR at 6 months (p<0.05) with 16/20 eyes achieving visual acuity equal or better than 0.09 logMAR (Snellen equivalent 6/7.5). CCT decreased from 623 ± 52 to 537 ± 31 um at 6 months (p<0.05). ECL at 6 months was 27.9 ± 16.7%. No major intraoperative complications were noted. One eye developed a major detachment (>1/3) requiring rebubbling.

Conclusions:

Our results indicate that this novel alternative for DMEK tissue insertion using the pull-through technique with an infusion forceps is safe and efficacious with visual outcomes and cell loss comparable to conventional techniques. It could allow for increased predictability and control of tissue unfolding, making it suitable for novice DMEK surgeons.

Financial Disclosure:

... gains financially from product or procedure presented