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A. Kobayashi, H. Yokogawa, K. Sugiyama; Clinical Results with the Neusidle Corneal Inserter (New Donor Inserter for DSAEK) for Small Asian Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):772.
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© ARVO (1962-2015); The Authors (2016-present)
One of the problems of Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) is donor endothelial cell damage that occurs during donor insertion into the anterior chamber. This is a serious problem especially for Asian eyes, since they tend to have shallow anterior chamber with small corneal diameter. The purpose of this study is to investigate the clinical outcome of a newly developed donor inserter (Neusidle Corneal Inserter: NCI, Fischer Surgical Inc.) for DSAEK in small Asian eyes.
Two women and one male (mean, 69.3 years) with bullous keratopathy underwent non-Descemet’s Stripping Automated Endothelial Keratoplasty (nDSAEK). All patients had a small cornea with approximately 9.0 mm or less in diameter. Endothelial cell counts, postoperative visual acuity after 6 months, and complications during surgery were examined.
In one case, donor release in the anterior chamber was difficult; the use of spatula from side port was effective to release the donor in this situation. The remaining cases had no difficulties during donor insertion. There were no other complications during and after the surgery in all cases. All cases (100%) reached best spectacle corrected visual acuity of 20/30 after 6 months. Mean postoperative endothelial cell counts after 6 months was 2587.3/mm2, a 14.3% reduction compared with donor endothelial cell counts.
In this preliminary small case series, NCI enabled to protect endothelial cells quite effectively during donor insertion in DSAEK. It was proven that NCI is effective for small Asian eyes, and possibly for pediatric cases.
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