A Prospective Study Comparing EndoGlide and Busin Glide Insertion Techniques in Descemet Stripping Endothelial Keratoplasty

Abstract

To compare a new insertion method using an EndoGlide (Angiotech/Network Medical Products) with the standard Busin glide (Moria USA) assisted insertion of the posterior lamellar corneal graft in Descemet stripping endothelial keratoplasty (DSEK). Prospective, consecutive, comparative, nonrandomized study. Surgery was performed between October 2008 and October 2010 in 52 eyes of 52 consecutive patients with endothelial dysfunction suitable for DSEK. Twenty-two consecutive eyes underwent the new EndoGlide-assisted insertion of donor lenticule and 30 eyes underwent the surgery using the Busin glide. Six-month follow-up data are available for all patients. Clinical details, best-corrected visual acuity, manifest refraction, intraoperative and postoperative complications, and corneal endothelial cell loss were assessed at 6 months after DSEK. At 6 months after surgery, the best-corrected visual acuity was similar in both groups (0.13 logarithm of the minimal angle of resolution in the EndoGlide eyes as compared with 0.15 logarithm of the minimal angle of resolution in the Busin group; P = .34). Mean spherical equivalent was 0.65 diopter (D) and 0.51 D, and mean refractory cylinder was 1.39 D and 1.08 D, respectively (P = .40). The endothelial cell loss was much lower in the EndoGlide group (25.76%) as compared with the Busin group (47.46%; P < .0001). In conclusion, the new EndoGlide results in significantly less endothelial cell loss than Busin glide donor insertion in DSEK. The visual outcomes and refractive changes were similar in both groups.