Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion

Mehrnaz Ighani, Sezen Karakus, Allen O Eghrari Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Allen O EghrariDivision of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopki...

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Autores principales:	Ighani M, Karakus S, Eghrari AO
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Descemet membrane endothelial keratoplasty corneal transplantation DMEK injector Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b84b630ce306438aa614b8e88c9b0638
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spelling	oai:doaj.org-article:b84b630ce306438aa614b8e88c9b06382021-12-02T06:51:30ZClinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion1177-5483https://doaj.org/article/b84b630ce306438aa614b8e88c9b06382019-09-01T00:00:00Zhttps://www.dovepress.com/clinical-outcomes-of-descemet-membrane-endothelial-keratoplasty-using--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mehrnaz Ighani, Sezen Karakus, Allen O Eghrari Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Allen O EghrariDivision of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 1800 Orleans Street, Woods 375, Baltimore, MD 21287, USATel +1 410 955-5490Fax +1 410 614-9172Email allen@jhmi.eduPurpose: 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.Keywords: Descemet membrane endothelial keratoplasty, corneal transplantation, DMEK injectorIghani MKarakus SEghrari AODove Medical PressarticleDescemet membrane endothelial keratoplastycorneal transplantationDMEK injectorOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1869-1876 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Descemet membrane endothelial keratoplasty corneal transplantation DMEK injector Ophthalmology RE1-994
spellingShingle	Descemet membrane endothelial keratoplasty corneal transplantation DMEK injector Ophthalmology RE1-994 Ighani M Karakus S Eghrari AO Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
description	Mehrnaz Ighani, Sezen Karakus, Allen O Eghrari Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Allen O EghrariDivision of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 1800 Orleans Street, Woods 375, Baltimore, MD 21287, USATel +1 410 955-5490Fax +1 410 614-9172Email allen@jhmi.eduPurpose: 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.Keywords: Descemet membrane endothelial keratoplasty, corneal transplantation, DMEK injector
format	article
author	Ighani M Karakus S Eghrari AO
author_facet	Ighani M Karakus S Eghrari AO
author_sort	Ighani M
title	Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
title_short	Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
title_full	Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
title_fullStr	Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
title_full_unstemmed	Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion
title_sort	clinical outcomes of descemet membrane endothelial keratoplasty using the bonfadini-todd injector for graft insertion
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/b84b630ce306438aa614b8e88c9b0638
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Clinical Outcomes Of Descemet Membrane Endothelial Keratoplasty Using The Bonfadini-Todd Injector For Graft Insertion

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