Clinical Evaluation of a New Donor Graft Inserter for Descemet’s Stripping Automated Endothelial Keratoplasty

Abstract

To present clinical outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using a newly developed donor graft inserter, the Tan EndoGlide (AngioTech, Reading, PA/Network Medical Products, North Yorkshire, UK). Six eyes of six patients with bullous keratopathy were treated with DSAEK using the Tan EndoGlide. Intraoperative and postoperative complications, postoperative donor endothelial cell densities (ECDs), and best-corrected visual acuity were recorded. Five cases had no difficulties during donor graft loading into the Tan EndoGlide; however, the donor graft was folded inside-out into the Tan EndoGlide in one case, resulting in severe endothelial cell loss. All patients achieved a visual acuity of 20/63 or better at 12 months, with four patients reaching better than 20/32. Excluding the case with the graft folded inside-out, postoperative ECDs were 2,041 cells/mm(2) (mean loss: 22.9%) at 6 months and 1,973 cells/mm(2) (mean loss: 24.6%) at 12 months. In this small preliminary series, the clinical outcome with the Tan EndoGlide was comparable to or better than that achieved with the conventional technique. Additional studies using a larger number of patients are required to fully evaluate the usefulness and potential advantages of this new donor graft inserter.