Novel Delivery Method to Reduce Endothelial Injury in Decemet tripping Automated Endothelial Keratoplaty Original Reearch Article

Purpoe To preent a novel technique to deliver the endothelial graft in mall inciion Decemet tripping Automated Endothelial Keratoplaty (DAEK) and to compare graft trauma between forcep delivery and the novel technique. Deign Laboratory invetigation with an interventional cae report. Method Ten pair of human donor cornea were ectioned uing an automated microkeratome ytem (Moria ALTK ytem, Antony, France). The recipient model wa prepared by creating a 3 mm clear corneal wound in another human donor cornea. For each pair of cornea, one endothelial graft underwent ingle-fold delivery with forcep, while the other wa delivered with the novel cartridge baed technique. Each graft wa tained with 0.25% trypan blue and 0.2% alizarin red, and digital photomicrograph were taken. A proportion of graft injury wa calculated and difference were analyzed. ubequently, a patient requiring DAEK underwent the modified novel inertion technique. Reult After inertion, the mean proportion of graft endothelial injury from forcep delivery through the ex vivo model wa 26.02% (n = 10, tandard deviation [D] ± 14.85%). The mean proportion of graft endothelial injury from cartridge delivery wa 9.85% (n = 10, D ± 4.33%). The median difference between the two method wa −13%, repreenting le endothelial injury with the cartridge. Thi difference wa tatitically ignificant (P = .006). The patient who underwent DAEK with thi technique had improved viual acuity and a clear graft at five month. Concluion In our urgical model, inerting an endothelial graft through a mall corneal wound uing a novel cartridge-baed technique created ignificantly le endothelial damage than with forcep inertion. Clinically, thi technique wa performed without complication.