A Device for Preloaded, Trifolded Grafts to Facilitate Descemet Membrane Endothelial Keratoplasty-Reference-Cited by-同舟云学术

A Device for Preloaded, Trifolded Grafts to Facilitate Descemet Membrane Endothelial Keratoplasty

Published:2019-09-20 Issue:4 Volume:13 Page:
ISSN:1932-6181
Container-title:Journal of Medical Devices
language:en
Short-container-title:

Author:

Chiang Eric¹,Chen Conan²,Barnes Kali³,Chaurasia Akash⁴,Rosen Allison⁵,Solar Steven⁶,Wiener Batya⁷,Cai Stephanie⁸,Subramanya Anshul⁹,Vora Parth¹⁰,Durr Nicholas J.¹¹,Eghrari Allen O.¹²,Allen Robert¹³

Affiliation:

1. Department of Biomedical Engineering, Johns Hopkins University, 4 E. 32nd Street, Apartment 407, Baltimore, MD 21218

2. Department of Biomedical Engineering, Johns Hopkins University, 13792 East 13th Circle, Unit C103, Aurora, CO 80011

3. Department of Biomedical Engineering, Johns Hopkins University, 100 West University Parkway, Apartment 9N, Baltimore, MD 21218

4. Department of Biomedical Engineering, Johns Hopkins University, 3900 North Charles Street Apartment 811, Baltimore, MD 21218

5. Department of Biomedical Engineering, Johns Hopkins University, 9 East 33rd Street, Apartment 922, Baltimore, MD 21218

6. Department of Biomedical Engineering, Johns Hopkins University, 3339 North Charles Street, Wolman 3645, Baltimore MD 21218

7. Department of Biomedical Engineering, Johns Hopkins University, 3510 North Charles Street, AMRII #2569, Baltimore, MD 21218

8. Department of Biomedical Engineering, Johns Hopkins University, 3700 North Charles Street, Apartment 210 Baltimore, MD 21218

9. Department of Biomedical Engineering, Johns Hopkins University, 9 East 33rd Street, Apartment 1006, Baltimore, MD 21218

10. Department of Biomedical Engineering, Johns Hopkins University, Bradford, 3301 Street Paul Street, Baltimore, MD 21218

11. Department of Biomedical Engineering, Johns Hopkins University, Clark 100, 3400 North Charles Street, Baltimore, MD 21218

12. Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, 600 North Wolfe Street, Baltimore, MD 21287

13. Albert Einstein School of Medicine, Department of Obstetrics & Gynecology and Women's Health, Yeshiva University, 1300 Morris Park Avenue Belfer Building, Room 512, Bronx, NY 10461

Abstract

Abstract Descemet membrane endothelial keratoplasty (DMEK) is the most efficacious partial endothelial keratoplasty, offering the highest likelihood of 20/20 vision and the shortest recovery times. However, current devices do not effectively address the difficult step of unrolling the corneal graft within the eye which is the greatest barrier to DMEK adoption. Here, we present the design, development, and testing of a novel device that simplifies and standardizes DMEK graft transplantation. The patent-pending cartridge facilitates the trifold technique, a graft preparation method that allows the graft to naturally unroll in the eye and reduces time-consuming manipulation steps required in alternative techniques. Injection molding was used to manufacture devices which were tested with research-grade corneal grafts. The cartridge's design allows it to fit into a typical corneoscleral incision, maintains trifolded grafts (p = 0.006), and reduces endothelial cell loss (ECL) (p = 0.049). These results demonstrate that the device introduced here is suitable for DMEK and may simplify this procedure for corneal surgeons.

Publisher

ASME International

Subject

Biomedical Engineering,Medicine (miscellaneous)

Link

http://asmedigitalcollection.asme.org/medicaldevices/article-pdf/doi/10.1115/1.4043739/6431220/med_013_04_044502.pdf

Reference13 articles.

1. 2016 Eye Banking Statistical Report;Eye Bank Association of America,2017

2. Effect of Cornea Donor Graft Thickness on the Outcome of Descemet Stripping Automated Endothelial Keratoplasty Surgery;Am. J. Ophthalmol.,2013

3. Perfecting Posterior Corneal Grafts,2016

4. Endothelial Keratoplasty: From DLEK to DMEK;Middle East Afr. J. Ophthalmol.,2010

5. Descemet Membrane Endothelial Keratoplasty (DMEK): Two-Year Results;Arch. Soc. Esp. Ofthalmol.,2009

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