Compare Dsaek Insertion Endothelial Cell Damage Of Pull-Through Glide, Forceps And A Preloaded Injectable Technique In A Hybrid Anterior Chamber

Compare DSAEK insertion endothelial cell damage of pull-through glide, forceps and a preloaded injectable technique in a hybrid anterior chamber

Experimental study performed at Lions Eye Institute for Transplant and Research

20 DSAEK grafts were included. All were processed, stained (Trypan blue), photographed and inserted into BIONIKO LINK™️ models: 5 via forceps, 5 via a preloaded injectable (Weiss Ophthalmic Cannula- LEITR 3.0(WOCL 3.0) and 10 via 2 variations with Busin glide [5 with graft loaded over the glide tunnel (BGV1) and 5 where graft was loaded on the side of the glide (BGV2)]. After Insertion, each graft was re-stained and photographed. Percentage of damaged cells was calculated via ImageJ software. Statistical analyses were performed using SASS 9.4

 Mean endothelial cell loss of BGV1, BGV2, forceps and WOCL 3.0 techniques were 22.6, 26.9, 23.1 and 7.7%, respectively. Median cell loss was statistically different in each WOCL 3.0 comparison [BGV1 vs WOCL 3.0 (p=0.04), forceps vs WOCL 3.0 (0.04), BGV2 vs WOCL 3.0 (0.04)]. Median cell loss was not statistically different in the other comparisons [BGV1 vs BGV2 (0.53), BGV1 vs forceps (0.95), BGV2 vs forceps (0.66)]. BGV1, BGV2 and forceps technique mean endothelial cell losses did not differ significantly from one another with Loss-Tukey grouping, whereas WOCL 3.0 mean endothelial cell loss was statistically different from the other 3 techniques

Mean endothelial cell loss was significantly lowest in the Weiss Ophthalmic Cannula LEITR 3.0 group. Median percent cell loss did not differ significantly between forceps and Busin glide insertions but did significantly differ in each group that included the Weiss Ophthalmic Cannula LEITR 3.0 for comparison