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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-08-2017 | Cornea

Comparison of Descemet stripping under continuous air flow, manual air injection and balanced salt solution for DMEK: a pilot study

Authors: I. E. Gabbay, I. Bahar, Y. Nahum, E. Livny

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2017

Abstract

Background

Descemet’s membrane endothelial keratoplasty (DMEK) involves removal of the recipient’s Descemet membrane (DM) prior to transplanting the donor’s DM. When using balanced salt solution (BSS) or ophthalmic viscosurgical devices (OVDs), visualization of the host’s DM during its stripping may be inadequate and may result in Descemet remnants and could lead to sub-optimal surgical results. Previous articles described excellent visualization when utilizing air injection but this requires repeated air injection into the anterior chamber (AC). We present a pilot study that compares different techniques under which DM stripping can be performed: with continuous automated air infusion, with manual air infusion, and with BSS.

Methods

We retrospectively compared video footage of DM stripping with BSS, with continuous air and with manual injection of air into the AC to determine DM stripping duration and the number of times the surgeon had to insert and retrieve a surgical instrument from the AC.

Results

Thirty videos of 10 consecutive cases of the three DM stripping techniques were evaluated. DM stripping duration was 3.26 (±1.32), 3.92 (±1.2) and 12.9 (±3.98) minutes for BSS, continuous air flow, and manual air injection, respectively. Frequency of instrument retrieval (FIR) was 3.6 (±1.71), 1.5 (±0.71) and 15.1 (±3.28) for BSS, continuous air flow, and manual air injection, respectively. Continuous air flow and BSS were both statistically different than manual air injection into the AC (p < 0.05), but did not differ from one another statistically.

Conclusion

DM stripping during posterior lamellar surgery is imperative for favorable post-operative results and prevention of complications. Performing this step under air in the AC contributes to better visualization and an efficient surgery.

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Title: Comparison of Descemet stripping under continuous air flow, manual air injection and balanced salt solution for DMEK: a pilot study
Authors: I. E. Gabbay
I. Bahar
Y. Nahum
E. Livny
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-017-3675-0

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Springer Medicine

Comparison of Descemet stripping under continuous air flow, manual air injection and balanced salt solution for DMEK: a pilot study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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