Universität zu Köln

Siebelmann, Sebastian, Matthaei, Mario, Hoerster, Robert, Cursiefen, Claus and Bachmann, Bjoern (2017). Lutein and Brilliant Blue-Based Dye for Donor Preparation and Transplantation in Descemet Membrane Endothelial Keratoplasty. Cornea, 36 (4). S. 440 - 445. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose: Trypan blue (TB) is used for visualization of the endothelium-Descemet membrane graft during Descemet membrane endothelial keratoplasty (DMEK). However, TB is assumed to have a dose-dependent toxic effect on the corneal endothelium. We retrospectively compared a lutein/zeaxanthin and Brilliant Blue (LZ/BB)-based dye for preparation and transplantation of the graft in DMEK to TB. Methods: In 20 patients, a dye composed of 1% LZ /0.025% BB was used, and in 22 patients, 0.06% TB was used for graft visualization in DMEK. We evaluated the rebubbling rate, best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD) before and 3 and 6 months after transplantation. Results: Staining of endothelium-Descemet membrane with LZ/BB was faint but sufficient. There was no significant difference between both groups, except in CCT after 3 months, which was lower in the LZ/ BB group (P = 0.02). In the LZ/BB group, BSCVA improved from 0.48 +/- 0.39 before DMEK to 0.19 +/- 0.09 after 6 months (P < 0.05) (20% rebubbling rate). Donor ECD decreased from 2735 +/- 259 cells/m(2) preoperatively to 1876 +/- 316 cells/mm(2) (P < 0.0001) at 6 months (31.4%). CCT decreased from 642 +/- 130 mu m preoperatively to 519.8 +/- 38 mm (P < 0.0001) at 6 months. In the TB group, BSCVA improved from 0.43 +/- 0.27 to 0.17 +/- 0.14 (P = 0.0003) at 6 months (30% rebubbling rate). ECD decreased from 2825 +/- 263 to 1777 +/- 302 cells/ mm(2) (P < 0.0001) after 6 months (36.3%), CCT from 638 +/- 48 mu m preoperatively to 531 +/- 48 mu m (P < 0.0001) at 6 months. Conclusions: LZ/BB-based dyes are suitable for DMEK with outcomes comparable to TB. However, available formulas result in faint staining, discouraging their routine use in donors with assumed difficult preparation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoerster, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-235496
Journal or Publication Title:	Cornea
Volume:	36
Number:	4
Page Range:	S. 440 - 445
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPTICAL COHERENCE TOMOGRAPHY; TRYPAN BLUE; FOLLOW-UP; CELL-LOSS; DMEK; ZEAXANTHIN; BIOCOMPATIBILITY; SURGERY Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23549