Purpose:
To present a novel instrument and technique for transporting corneal tissue while performing Descemet Stripping with Endothelial Keratoplasty(DSEK)
Methods:
An injector was designed for transporting a 150 micron corneal button into the anterior chamber of a recipient eye. The injector allows safe transportation of the corneal button via an outer protective cartridge tip that inserts through a 4 mm corneo-scleral wound. The cornea button is fixated to an inner movable tip within the injector by constant vacuum suction applied to the stromal side of the corneal button. The movable tip carries the corneal button through the injector outer cartridge and into the anterior chamber. While delivering the corneal button into the anterior chamber, the injector provides constant anterior chamber fluid maintenance through a separate port within the injector, thus maintaining chamber stability in the process of transportation. Confocal cell viability studies were performed to compare the effect of this technique versus forceps manipulation of corneal tissue as performed in DSEK. Donor Goat and Cow eyes were used for the experiments.
Results:
Gross analyses demonstrate superior technical advantages of the injector over current methods of corneal button transportation for DSEK. Confocal viability studies demonstrate greater protection to the endothelium using this technique versus standard forceps technique of transporting corneal tissue into the anterior chamber.
Conclusions:
Vacuum-assisted delivery of corneal tissue through an injector provides a safe and technically superior method for Descemet Stripping with Endothelial Keratoplasty. Further analysis is required to prove the clinical efficacy of this injector.
Keywords: cornea: endothelium • transplantation • cornea: clinical science