Clinical outcomes of the intraocular lens injector for Descemet stripping automated endothelial keratoplasty in patients with iridocorneal endothelial syndrome

Abstract

Abstract Purpose: To report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) performed in iridocorneal endothelial (ICE) syndrome patients using the intraocular lens injector (injector), which was compared with those using the Busin glide. Methods: In this retrospective, case-control study, we evaluated the outcomes of DSAEK performed using the injector (n=7) or the Busin glide (n=7) for patients with ICE syndrome. Graft position and postoperative complications were recorded. Best-corrected visual acuity (BCVA) and endothelial cell loss (ECL) were monitored over a 12-month follow-up period. Results: DSAEK was conducted successfully in the 14 cases, and no one was noted with graft dislocation during the follow-ups. The BCVA improved from the preoperative 1.18±0.60 to 0.41±0.40 at 12-month after operation (P < 0.001), with no significant difference between the two groups (P=0.455). ECL at 1 month after DSAEK was 21.56±12.28% in the injector group, which was significantly lower than 36.84±11.18% of the Busin group (P=0.032). No complications were observed in the 14 cases intraoperatively or postoperatively. Conclusions: The graft injector to deliver the endothelial graft for DSAEK may cause significantly less endothelial cell damage than the pull-through technique using the Busin glide. The injector allows safe endothelial graft delivery without the need of anterior chamber irrigation, which increase the ratio of successful graft attachment. Trial registration number: ChiCTR2100048371 Trial registration date: 2021-07-06 (retrospectively registered)