TY - JOUR
T1 - Busin Guide vs Forceps for the Insertion of the Donor Lenticule in Descemet Stripping Automated Endothelial Keratoplasty
AU - Bahar, Irit
AU - Kaiserman, Igor
AU - Sansanayudh, Wiwan
AU - Levinger, Eliya
AU - Rootman, David S.
N1 - Funding Information:
The authors indicate no financial support. Dr Bahar is a recipient of fellowship funding from the Schwartz Reisman Foundation. Involved in design and conduct of study (I.B., E.L., I.K., W.S., D.S.R.); collection (W.S., I.B.), management (E.L., W.S., D.S.R.), analysis (I.K.), and interpretation of data (I.K., I.B., D.S.R.); and preparation (I.K., I.B.), review (D.S.R.), or approval of the manuscript (I.B., I.K., E.L., W.S., D.S.R.). This study was approved by the Toronto University Health Network Review Ethics Board with adherence to the Declaration of Helsinki.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - Purpose: To compare two insertion methods in Descemet stripping automated endothelial keratoplasty (DSAEK): Busin guide-assisted vs Forceps-assisted insertion of the corneal lenticule graft. Design: Prospective, consecutive, comparative, nonrandomized study. Methods: setting: Cornea clinic at the Toronto Western Hospital. study population: Sixty-three eyes of 63 consecutive patients were included. All patients underwent DSAEK for Fuchs endothelial dystrophy, pseudophakic bullous keratopathy, aphakic bullous keratopathy, failed graft, or iridocorneo endothelial syndrome. Twenty-six consecutive donor discs were inserted with the Busin guide and 37 consecutive eyes underwent forceps assisted insertion of the donor. main outcome measures: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, corneal endothelial cell loss, and postoperative complications. Results: Busin guide-assisted DSAEK group had significantly worse UCVA and lower donor endothelial cell counts preoperatively. No significant differences were noted in the intraoperative or postoperative complications. Six months following surgery, BCVA was not significantly different between groups: 20/37 in the Busin guide-assisted DASEK group vs 20/42 in the Forceps-assisted group (P = .39). Mean spherical equivalent was -0.02 diopters (D) and 0.82 D (P = .06), and mean refractive cylinder was 2.2 D and 1.31 D (P = .0006), respectively. Endothelial cell loss was significantly lower in the Busin guide-assisted DASEK group: 25% loss vs 34.3% loss in the Forceps-assisted DSAEK group. (P = .04). Conclusions: Although visual outcomes were not different between the groups studied, Busin guide-assisted DSAEK resulted in lower percentage of endothelial cell loss compared with forceps insertion, six months following surgery.
AB - Purpose: To compare two insertion methods in Descemet stripping automated endothelial keratoplasty (DSAEK): Busin guide-assisted vs Forceps-assisted insertion of the corneal lenticule graft. Design: Prospective, consecutive, comparative, nonrandomized study. Methods: setting: Cornea clinic at the Toronto Western Hospital. study population: Sixty-three eyes of 63 consecutive patients were included. All patients underwent DSAEK for Fuchs endothelial dystrophy, pseudophakic bullous keratopathy, aphakic bullous keratopathy, failed graft, or iridocorneo endothelial syndrome. Twenty-six consecutive donor discs were inserted with the Busin guide and 37 consecutive eyes underwent forceps assisted insertion of the donor. main outcome measures: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, corneal endothelial cell loss, and postoperative complications. Results: Busin guide-assisted DSAEK group had significantly worse UCVA and lower donor endothelial cell counts preoperatively. No significant differences were noted in the intraoperative or postoperative complications. Six months following surgery, BCVA was not significantly different between groups: 20/37 in the Busin guide-assisted DASEK group vs 20/42 in the Forceps-assisted group (P = .39). Mean spherical equivalent was -0.02 diopters (D) and 0.82 D (P = .06), and mean refractive cylinder was 2.2 D and 1.31 D (P = .0006), respectively. Endothelial cell loss was significantly lower in the Busin guide-assisted DASEK group: 25% loss vs 34.3% loss in the Forceps-assisted DSAEK group. (P = .04). Conclusions: Although visual outcomes were not different between the groups studied, Busin guide-assisted DSAEK resulted in lower percentage of endothelial cell loss compared with forceps insertion, six months following surgery.
UR - http://www.scopus.com/inward/record.url?scp=58249102260&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2008.08.029
DO - 10.1016/j.ajo.2008.08.029
M3 - Article
AN - SCOPUS:58249102260
SN - 0002-9394
VL - 147
SP - 220-226.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 2
ER -