Descemet's stripping pseudo endothelial keratoplasty (DSPEK)

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Tuesday 08/09/2015 | 08:00-10:30

Paper Time: 08:30

Venue: Room 10

First Author: : O.Daphna ISRAEL

Co Author(s): :    A. Marcovich   I. Bahar                 

Abstract Details

Purpose:

Descemet's Stripping Pseudo Endothelial Keratoplasty (DSPEK) is a posterior lamellar surgery in which the recipient's Descemet's membrane is replaced by a silicone implant. This implant acts as an artificial fluid barrier in the posterior surface of the cornea.To assess the feasibility of DSPEK surgery in an animal model, and to investigate its efficacy.

Setting:

Animal model

Methods:

18 rabbits underwent Descemet's stripping in their left eye, in 13 rabbits an 8-10.5 mm silicon layer was implanted using an air bubble for its attachment (in a similar way to DSAEK operation). 5 rabbits were left as a control group. Follow up was 1-16 weeks and still ongoing. We used Slit-lamp, pachymetry, histology and anterior segment OCT for the follow up.

Results:

The average corneal thickness prior to surgery was 374 microns (+- 20), the average corneal thickness of the control eyes was 1650 (+- 400) microns. Five out of the 12 eyes tested demonstrated primary failure due to implant detachment, 7 rabbits maintained a clear cornea for a week, followed by the development of corneal edema, 4 rabbit showed a remark recovery of corneal edema following implant exchange with a long follow up, There was no apparent inflammatory reaction during the follow up in the tested eyes.

Conclusions:

The preliminary results suggest a possibility of using a fluid barrier as a substitute for endothelium in the treatment of corneal edema: As long as an attached implant was achieved, a positive effect on corneal edema was demonstrated. Larger group samples and longer period of observation is needed.

Financial Interest:

One of the authors is employed by a for-profit company with an interest in the subject of the presentation