Abstract
Purpose: :
To report preliminary data of the post operative loss of endothelial cells in a small case series of patients who underwent Descemet’s stripping automated endothelial keratoplasty using the surgical technique of donor graft insertion with the NCI injector by Fischer Surgical.
Methods: :
Charts of patients who had undergone Descemet’s stripping automated endothelial keratoplasty using the Fischer NCI injector were retrospectively reviewed and those who had received endothelial cell counts by specular microscopy at a minimum of four months post operatively were selected to be included in this case series. The donor grafts’ preoperative endothelial cell counts reported by the eye bank were recorded and compared to the post operative endothelial cell counts. If multiple sets of cell counts had been performed on the same eye at different points in time, the last recorded counts were used. The percentages of endothelial cells lost were calculated and the results compared to the percentage of endothelial cell loss found in the published literature for the more commonly used forceps technique.
Results: :
Eighteen eyes met selection criteria. The average pre-operative cell count was 2993. The average post operative cell count was 2168 at an average follow up time of 9 months (Range for the time of cell count acquisition was 4-17 months). This represented a 27.5% average loss with a standard deviation of 14.4%.
Conclusions: :
Graft insertion with the NCI injector has the potential advantage of increased ease of use for the more novice surgeon. In a small case series, the average post operative endothelial cell loss for this insertion technique was 27.5% at an average of 9 months following Descemet’s stripping automated endothelial keratoplasty. This rate of cell loss appears comparable to the 34% loss at six months (with relative stability up to one year) previously reported in the literature by Dr. Terry for graft insertion with the Charlie forceps. While this represents only preliminary retrospective data, it is promising that cell loss with this technique appears to be at least comparable to the more traditional forceps technique.
Keywords: cornea: endothelium • cornea: clinical science