Universität zu Köln

Siebelmann, Sebastian, Janetzko, Mona, Koenig, Peter, Scholz, Paula, Matthaei, Mario, Haendel, Alexander, Cursiefen, Claus and Bachmann, Bjoern (2020). Flushing Versus Pushing Technique for Graft Implantation in Descemet Membrane Endothelial Keratoplasty. Cornea, 39 (5). S. 605 - 609. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose: Descemet membrane endothelial keratoplasty (DMEK) has developed into a safe procedure for the replacement of diseased corneal endothelium. However, DMEK still results in a significant donor endothelial cell loss. Here, we compare 2 different graft implantation techniques. Methods: Twenty patients undergoing DMEK, where a DMEK injection cartridge was used to flush the graft into the anterior chamber (G-38635 single-use DMEK-Cartridge; Geuder AG, Heidelberg, Germany; group A), were retrospectively compared with 20 patients, where a standard lens injection cartridge (AT.Smart Cartridge; Carl Zeiss Meditec AG, Jena, Germany; group B) was used to push the graft with a plunger. Outcome parameters were intraoperative orientation of the graft, insertion-to-attachment time, rebubbling rates, and postoperative best spectacle-corrected visual acuity, endothelial cell count, and central corneal thickness after 12 months. The surfaces of both cartridges were evaluated by scanning electron microscopy. Results: In group A, the insertion-to-attachment time was significantly higher (P = 0.003). Initially, the graft was oriented correctly in 40% of the patients in group A compared with 90% in group B (P = 0.001). No differences were obtained between both groups regarding central corneal thickness, endothelial cell count or best spectacle-corrected visual acuity, and rebubbling rates after 12 months. Scanning electron microscopy analysis demonstrated a rougher and sharper surface of the shooter of group B. Conclusions: This study shows significant differences between both insertion techniques regarding correct graft orientation directly after graft implantation leading to prolonged insertion-to-attachment time when the graft is flushed instead of pushed into the anterior chamber.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Siebelmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Janetzko, Mona UNSPECIFIED UNSPECIFIED UNSPECIFIED Koenig, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholz, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Haendel, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-335114
DOI:	10.1097/ICO.0000000000002239
Journal or Publication Title:	Cornea
Volume:	39
Number:	5
Page Range:	S. 605 - 609
Date:	2020
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DMEK; 20-PERCENT; AIR Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33511