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Victoria S. Chang, Jeremy B. Wingard, Roheena M. Kamyar, Deepinder Dhaliwal, Leela Raju, Francis Mah; Comparison of Insertion Methods of Donor Lenticule in Descemet's Stripping Automated Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2012;53(14):39. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the following insertion techniques of donor lenticules in Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery: Forceps insertion, Busin Technique, and Neusidl corneal inserter (NCI).
Setting: UPMC Eye Center, Pittsburgh, PAStudy Population: Forty eyes of thirty-eight patients were included in this study. Average age of the patients was 73.45 years. All visual acuity calculations employed LogMAR conversions. Average preoperative BCVA was 20/100. Indications for DSAEK in the study population included Fuchs’ endothelial dystrophy, pseudophakic bullous keratopathy (PBK), and previous graft failure. Eleven donor disc were inserted with forceps using the "taco" fold method, eighteen discs were inserted with the Busin glide, and ten discs were inserted using the NCI device.Main outcome measures: Best corrected visual acuity (BCVA), intraoperative, and postoperative complications at twelve months following surgery.
There were no significant differences in postoperative BCVA at 12 months between the 3 insertion technique groups (P= 0.152). In addition, no significant differences in postoperative complications were found (p=0.508) using analysis of variance between groups (ANOVA). Postoperative complications included graft dislocation, pupillary block glaucoma, high postoperative astigmatism, inflammation, and steroid-response glaucoma. At twelve months after surgery, all three groups had a Snellen equivalent close to 20/63, with a range of 20/20 to 20/80.
Three insertion techniques, "taco" fold, Busin technique, and NCI, did not result in significantly different visual outcomes or postoperative complications at 12 months post surgically.
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