First Author: N.Hirji UNITED KINGDOM
Co Author(s): K. Yip T. Poole
Purpose:
To estimate the rate of endothelial cell loss in patients undergoing DSAEK using the EndoSaver endothelial graft injector device.
Setting:
: Frimley Park Hospital, United Kingdom
Methods:
The clinical notes of 26 consecutive patients undergoing DSAEK using the EndoSaver endothelial graft injector device (Ocular Systems, Inc., Winston-Salem, NC, USA) were retrospectively reviewed. All operations were performed by the same surgeon. For each patient, the endothelial cell count in the donor cornea was recorded, together with serial endothelial cell counts measured at outpatient visits following surgery. Note was made of any complications occurring during or soon after surgery. The duration of post-operative positioning and the need for re-bubbling were also documented.
Results:
Six patients in total were excluded from the study, 2 of whom had primary graft failure and 4 of whom were lost to follow-up. Mean endothelial cell loss at 1 week, 1 month and 5 months was 12.9%, 23.6% and 28.7% respectively in patients who underwent uncomplicated surgery without re-bubbling, and 37.1%, 42.3% and 61.1% respectively in patients who required re-bubbling. Of patients who positioned for an hour or less following surgery, 42.8% required re-bubbling for either complete or partial graft detachments. In patients who positioned for a minimum of 2 hours, re-bubbling was required in 7.7% of cases.
Conclusions:
Our results corroborate with preliminary studies that have been undertaken to evaluate endothelial cell loss in patients undergoing DSAEK using the EndoSaver endothelial graft injector, thereby supporting the use of this relatively new device in corneal graft surgery. We demonstrate similar rates of cell loss following uncomplicated surgery, but additionally show significantly higher rates of cell loss in patients undergoing complicated DSAEK surgery. Our results also suggest that a longer period of post-operative positioning reduces the need for re-bubbling, and this may ultimately lead to better patient outcomes.
Financial Disclosure:
No
