April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Descemet’s Stripping Endothelial Keratoplasty with a Forceps Insertion or a Donor Corneal Inserter
Author Affiliations & Notes
  • Jeanine Baqai
    Ophthalmology, Rush University Medical Center, Chicago, Illinois
  • Vanee Virasch
    Ophthalmology, Rush University Medical Center, Chicago, Illinois
  • Jonathan B. Rubenstein
    Ophthalmology, Rush University Medical Center, Chicago, Illinois
  • Footnotes
    Commercial Relationships  Jeanine Baqai, None; Vanee Virasch, None; Jonathan B. Rubenstein, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 750. doi:
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      Jeanine Baqai, Vanee Virasch, Jonathan B. Rubenstein; Descemet’s Stripping Endothelial Keratoplasty with a Forceps Insertion or a Donor Corneal Inserter. Invest. Ophthalmol. Vis. Sci. 2011;52(14):750.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To compare outcomes and complications of Descemet’s Stripping Endothelial Keratoplasty (DSEK) using forceps insertion versus a donor corneal inserter

Methods: : A retrospective chart review was performed of 53 consecutive procedures performed by a single surgeon on 37 patients at a tertiary care center. Patients who had undergone previous penetrating keratoplasty or who had end stage glaucoma, optic neuropathy, or macular disease were excluded from the study. Visual outcomes, cornea edema, and corneal haze were compared between patients undergoing lenticule insertion with forceps versus the donor corneal inserter.

Results: : This study included 37 patients with Fuchs’ Dystrophy (30 patients) and pseudophakic bullous keratopathy (7 patients). Forceps insertion was used for 41 procedures and the donor corneal inserter was used for 12 procedures. 6 patients required repeat DSEK. The differences in average post-operative visual acuity among the 2 groups undergoing DSEK were not statistically significant. The average post-operative day 1 uncorrected visual acuity (UCVA) was 20/317 for patients undergoing forceps insertion and 20/725 for patients undergoing insertion with the donor corneal inserter (p=0.54). The average post-operative month 1 best corrected visual acuity (BCVA) was 20/46 for patients undergoing forceps insertion and 20/64 for patients undergoing insertion with the donor corneal inserter (p=0.62). The average post-operative month 6 BCVA was the same (20/44) for patients undergoing forceps insertion and patients undergoing insertion with the donor corneal inserter (p=0.37). Rebubbling of the graft was needed in 12% of the forceps group and 8% of the donor corneal inserter group, which was not statistically significant. The incidence of corneal haze was 12% in the forceps group and 8% in the donor corneal inserter group, which was not statistically significant. Residual corneal edema occurred in 15% of the forceps group and 8% of the donor corneal inserter group, which was not statistically significant.

Conclusions: : Analysis of visual outcome, corneal edema, and corneal haze did not reveal a statistically significant difference when the donor lenticule was inserted with a forceps versus a donor corneal inserter. Additional analysis of the data at the one-year and two-year time points is ongoing to determine if statistically significant differences exist between visual acuity outcome, corneal edema, and corneal haze.

Keywords: transplantation • cornea: endothelium • cornea: clinical science 
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