Outcomes of Descemet's stripping endothelial keratoplasty (DSEK) using eye bank prepared pre-loaded grafts

Session Details

Session Title: Cornea: Surgical I

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

Paper Time: 08:36

Venue: Room 10

First Author: : S.Palioura USA

Co Author(s): :    K. Colby                    

Abstract Details

Purpose:

To evaluate the feasibility of DSEK using grafts pre-loaded by an Eye Bank in a commercially-available insertion device.

Setting:

Tertiary Ophthalmology Referral Center, Massachusetts Eye and Ear Infirmary, USA

Methods:

Retrospective review of thirty-five eyes (29 with Fuchs dystrophy and 6 with failed grafts) that underwent DSEK with donor tissue that was pre-cut, trephined, loaded into EndoGlide™ Ultrathin inserters at the Lions Eye Institute (Tampa, FL) and shipped overnight in storage media to the surgeon (KC). Main outcome measures included intra-operative and post-operative complications and endothelial cell density (ECD). The mean best-corrected visual acuity (BCVA) and mean central corneal thickness (CCT) at the last follow up visit were also reviewed.

Results:

One primary graft failure (2.8%), two rebubblings (5.7%) and one graft rejection (2.8%) occurred. Mean preoperative donor ECD was 2821 ± 199 cells/mm2. At 6 months post-operatively, the mean endothelial cell loss was 24.5 ± 16.6 %, which remained stable at 1 year (31.5 ± 17.9 %). Fuchs dystrophy patients had less cell loss at 1 year (27.9%) compared with graft failure patients (46.8%). Mean BCVA improved from 20/100 pre-operatively to 20/25 at a mean follow up of 1 year. Mean CCT was reduced from 711 ± 110 μm to 638 ± 66 μm at the last follow up visit.

Conclusions:

DSEK tissue pre-loaded by an eye bank can be used successfully without undo surgical complications or endothelial cell loss. Pre-loading reduces intra-operative tissue manipulation. Fuchs dystrophy patients have less cell loss than graft failure patients.

Financial Interest:

NONE