A prospective study comparing EndoGlide and Busin glide insertion techniques in descemet stripping endothelial keratoplasty.

PURPOSE To compare a new insertion method using an EndoGlide (Angiotech/Network Medical Products) with the standard Busin glide (Moria USA) assisted insertion of the posterior lamellar corneal graft in Descemet stripping endothelial keratoplasty (DSEK). DESIGN Prospective, consecutive, comparative, nonrandomized study. METHODS Surgery was performed between October 2008 and October 2010 in 52 eyes of 52 consecutive patients with endothelial dysfunction suitable for DSEK. Twenty-two consecutive eyes underwent the new EndoGlide-assisted insertion of donor lenticule and 30 eyes underwent the surgery using the Busin glide. Six-month follow-up data are available for all patients. Clinical details, best-corrected visual acuity, manifest refraction, intraoperative and postoperative complications, and corneal endothelial cell loss were assessed at 6 months after DSEK. RESULTS At 6 months after surgery, the best-corrected visual acuity was similar in both groups (0.13 logarithm of the minimal angle of resolution in the EndoGlide eyes as compared with 0.15 logarithm of the minimal angle of resolution in the Busin group; P = .34). Mean spherical equivalent was 0.65 diopter (D) and 0.51 D, and mean refractory cylinder was 1.39 D and 1.08 D, respectively (P = .40). The endothelial cell loss was much lower in the EndoGlide group (25.76%) as compared with the Busin group (47.46%; P < .0001). CONCLUSIONS In conclusion, the new EndoGlide results in significantly less endothelial cell loss than Busin glide donor insertion in DSEK. The visual outcomes and refractive changes were similar in both groups.

[1]  M. Terry,et al.  Endothelial cell loss after Descemet's stripping endothelial keratoplasty in a large prospective series. , 2008, Ophthalmology.

[2]  M. Balls,et al.  Organ culture , 1975, Nature.

[3]  D. Covert,et al.  Early results of small-incision Descemet's stripping and automated endothelial keratoplasty. , 2007, Ophthalmology.

[4]  S. Debanne,et al.  Descemet's stripping automated endothelial keratoplasty outcomes compared with penetrating keratoplasty from the Cornea Donor Study. , 2010, Ophthalmology.

[5]  E. Pels,et al.  A surgical technique for posterior lamellar keratoplasty. , 1998, Cornea.

[6]  J. Mehta,et al.  Descemet stripping automated endothelial keratoplasty with a graft insertion device: surgical technique and early clinical results. , 2011, American journal of ophthalmology.

[7]  M. Baudrimont,et al.  Evaluation of the Deswelling Period in Dextran‐Containing Medium After Corneal Organ Culture , 1997, Cornea.

[8]  M. Qureshi,et al.  Experience and 12-Month Results of Descemet-Stripping Endothelial Keratoplasty (DSEK) with a Small-Incision Technique , 2007, Cornea.

[9]  V. Perez,et al.  Descemet-Stripping Automated Endothelial Keratoplasty: Effect of Inserting Forceps on DSAEK Donor Tissue Viability by Using an In Vitro Delivery Model and Vital Dye Assay , 2007, Cornea.

[10]  David A. Price,et al.  Descemet's stripping endothelial keratoplasty five-year graft survival and endothelial cell loss. , 2011, Ophthalmology.

[11]  I. Bahar,et al.  Busin Guide vs Forceps for the Insertion of the Donor Lenticule in Descemet Stripping Automated Endothelial Keratoplasty. , 2009, American journal of ophthalmology.

[12]  F. Price,et al.  Endothelial cell loss after descemet stripping with endothelial keratoplasty influencing factors and 2-year trend. , 2008, Ophthalmology.

[13]  V. Scorcia,et al.  A modified technique for descemet membrane stripping automated endothelial keratoplasty to minimize endothelial cell loss. , 2008, Archives of ophthalmology.

[14]  Marianne O Price,et al.  Descemet's stripping with endothelial keratoplasty in 200 eyes: Early challenges and techniques to enhance donor adherence , 2006, Journal of cataract and refractive surgery.

[15]  J. Mehta,et al.  Glide insertion technique for donor cornea lenticule during Descemet's stripping automated endothelial keratoplasty. , 2007, Journal of cataract and refractive surgery.

[16]  I. Bahar,et al.  Suture-assisted vs forceps-assisted insertion of the donor lenticula during Descemet stripping automated endothelial keratoplasty. , 2008, American journal of ophthalmology.

[17]  K. Hammersmith.  Visual acuity, refractive error, and endothelial cell density six months after Descemet stripping and automated endothelial keratoplasty (DSAEK). , 2008 .

[18]  H. van Cleynenbreugel,et al.  Graft insertion during Descemet‐stripping automated endothelial keratoplasty: Pulling the graft inward , 2008, Journal of cataract and refractive surgery.

[19]  M. Busin.  DSAEK for the Treatment of Endothelial Disease: Results in the Initial 100 Cases , 2009, Klinische Monatsblatter fur Augenheilkunde.

[20]  M. Moshirfar,et al.  Corneal profile analysis after Descemet stripping endothelial keratoplasty and its relationship to postoperative hyperopic shift , 2008, Journal of cataract and refractive surgery.

[21]  M. Terry,et al.  Endothelial Cell Damage in Descemet Stripping Automated Endothelial Keratoplasty With the Underfold Technique: 6- and 12-Month Results , 2010, Cornea.

[22]  S. Anand,et al.  Endothelial Cell Survival and Graft Profile Analysis in Descemet Stripping Endothelial Keratoplasty , 2011, Cornea.

[23]  Mark S Gorovoy,et al.  Descemet-Stripping Automated Endothelial Keratoplasty , 2006, Cornea.

[24]  Terry Kim,et al.  Refractive Change After Descemet Stripping Automated Endothelial Keratoplasty Surgery and Its Correlation With Graft Thickness and Diameter , 2009, Cornea.

[25]  V. Scorcia,et al.  A prospective study comparing EndoGlide and Busin glide insertion techniques in descemet stripping endothelial keratoplasty. , 2012, American journal of ophthalmology.

[26]  R. Ritch,et al.  Spontaneous reattachment of Descemet stripping automated endothelial keratoplasty lenticles: a case series of 12 patients. , 2010, American journal of ophthalmology.