TY - JOUR
T1 - Clinical outcomes of descemet membrane endothelial keratoplasty using the bonfadini-todd injector for graft insertion
AU - Ighani, Mehrnaz
AU - Karakus, Sezen
AU - Eghrari, Allen O.
N1 - Funding Information:
The authors thank Ms. Jennifer Perkins, the senior medical office coordinator at the Division of Cornea, Cataract, and External Diseases of the Wilmer Eye Institute, who acquired donor tissue information from the eye banks. Some contents of this manuscript have been presented at the 2018 American Society for Cataract and Refractive Surgery and American Society of Ophthalmic Administrators (ASCRS ASOA) annual meeting. This research did not receive any external financial support from funding agencies in the public, commercial, or not-for-profit sectors.
Funding Information:
Dr Eghrari is supported by the Prevention of Blindness Sybil B and Harrington Special Scholar Award and has ownership interest in Treyetech and LuckyVision, LLC. Dr Eghrari reports personal fees from Keralink, outside the submitted work. In addition, Dr Eghrari has a patent DMEK insertion device pending. The authors report no other conflicts of interest in this work.
Publisher Copyright:
© 2019 Ighani et al.
PY - 2019
Y1 - 2019
N2 - Purpose: To evaluate the clinical outcomes of using an Alcon intraocular lens (IOL) B cartridge for graft insertion during Descemet membrane endothelial keratoplasty (DMEK). Patients and methods: We retrospectively reviewed medical charts of patients who underwent DMEK using the Bonfadini-Todd injector, composed of an Alcon IOL B cartridge connected to plastic tubing and a syringe, for graft insertion between May 2016 and August 2018. Patient demographics, diagnoses, donor information, visual acuity, intraocular pressure (IOP), graft position and attachment status, pachymetry, and postoperative complications were recorded. Results: Twenty-four eyes of 23 patients with an average age of 72.8 ± 10.0 years (range, 48-87 years) were included. Mean follow-up duration was 13.3 ± 6.6 months (range, 3-26 months). Twenty-one (87.5%) patients had a primary diagnosis of Fuchs endothelial dystrophy, two (8.3%) patients had bullous keratopathy and one (4.2%) had Peter’s anomaly. Sixteen (66.7%) cases combined phacoemulsification and IOL implantation. Best-corrected visual acuity improved from a median of 0.398 logMAR preoperatively to 0.097 logMAR (P <0.001) at last follow-up examination, and central corneal thickness decreased from a median of 651 µm to 533.5 µm (P <0.001). Nine of 24 patients (37.5%) required re-bubbling due to partial graft detachment with a mean time of 12.1 ± 9.2 days (range, 5-35 days). One patient (4.2%) developed graft failure after re-bubbling and underwent Descemet stripping endothelial keratoplasty. Conclusion: The Alcon IOL B cartridge for DMEK graft insertion is safe and simple.
AB - Purpose: To evaluate the clinical outcomes of using an Alcon intraocular lens (IOL) B cartridge for graft insertion during Descemet membrane endothelial keratoplasty (DMEK). Patients and methods: We retrospectively reviewed medical charts of patients who underwent DMEK using the Bonfadini-Todd injector, composed of an Alcon IOL B cartridge connected to plastic tubing and a syringe, for graft insertion between May 2016 and August 2018. Patient demographics, diagnoses, donor information, visual acuity, intraocular pressure (IOP), graft position and attachment status, pachymetry, and postoperative complications were recorded. Results: Twenty-four eyes of 23 patients with an average age of 72.8 ± 10.0 years (range, 48-87 years) were included. Mean follow-up duration was 13.3 ± 6.6 months (range, 3-26 months). Twenty-one (87.5%) patients had a primary diagnosis of Fuchs endothelial dystrophy, two (8.3%) patients had bullous keratopathy and one (4.2%) had Peter’s anomaly. Sixteen (66.7%) cases combined phacoemulsification and IOL implantation. Best-corrected visual acuity improved from a median of 0.398 logMAR preoperatively to 0.097 logMAR (P <0.001) at last follow-up examination, and central corneal thickness decreased from a median of 651 µm to 533.5 µm (P <0.001). Nine of 24 patients (37.5%) required re-bubbling due to partial graft detachment with a mean time of 12.1 ± 9.2 days (range, 5-35 days). One patient (4.2%) developed graft failure after re-bubbling and underwent Descemet stripping endothelial keratoplasty. Conclusion: The Alcon IOL B cartridge for DMEK graft insertion is safe and simple.
KW - Corneal transplantation
KW - DMEK injector
KW - Descemet membrane endothelial keratoplasty
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U2 - 10.2147/OPTH.S219742
DO - 10.2147/OPTH.S219742
M3 - Article
C2 - 31571824
AN - SCOPUS:85073465143
SN - 1177-5467
VL - 13
SP - 1869
EP - 1876
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
ER -