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Intra and postoperative influence of two different cartridges for transplant injection during Descemet’s membrane endothelial keratoplasty

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Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : S.Siebelmann GERMANY

Co Author(s): :    M. Janetzko   P. Konig   P. Scholz   M. Matthaei   C. Cursiefen   B. Bachmann        

Abstract Details


Descemet Membrane Endothelial Keratoplasty (DMEK) has become a safe and standardized method for the treatment of diseased corneal endothelium. Nonetheless, it was reported, that up to 30% of the transplanted endothelial cells do not survive the surgical procedure after one year. The here presented study investigates the influence of two different shooter cartridges on DMEK surgery and postoperative outcomes.


University Hospital of Cologne, Cologne, Germany.


20 patients undergoing DMEK using a glass made (group A) DMEK injection cartridge (Szurmann Cartridge, Geuder AG, Heidelberg, Germany) were retrospectively analyzed and compared to 20 patients, where a lens injection cartridge was used (group B) (AT.Smart Cartridge, Carl Zeiss Meditec AG, Jena, Germany). Read-out parameters were a) orientation of the graft after injection, b) injection-to-attachment time of the graft, c) postoperative endothelial cell count (ECC), central corneal thickness (CCT) and best-spectacle-corrected visual acuity (BSCVA) after 3 months. Moreover, the surfaces of both cartridges were investigated by scanning electron microscopy (SEM). Surgery was performed by one single, experienced surgeon (BB).


There were no preoperative differences between both groups. Injection-to-attachment time was significantly higher in group A (258.25 ± 133.9 s vs. 135.75 ± 77.6 s, p = 0.003). Directly after injection the grafts were orientated correctly in 40% of the patients from group A compared to 90 % in group B (p = 0.001). There were no differences between both groups regarding CCT, ECC or BSCVA after 3 months. SEM revealed a rougher and sharper surface of the group B shooter.


Our findings indicate significant differences in the intraoperative handling with prolonged injection-to-attachment time with shooters from group A. However, the postoperative outcome within the first 3 months shows comparable results. Long term data is needed to confirm these findings.

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