scholarly journals Influence of Donor Tissue Factors on Detachment Rate in DSAEK Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Daniel Demsey ◽  
Stephanie Baxter

Purpose. To determine whether the rate of graft detachment in patients undergoing the DSAEK procedure is influenced by the time elapsed between donor death and tissue implantation. Methods. Data on procedure outcome and donor tissue for patients undergoing the DSAEK procedure were reviewed. Data on time elapsed between harvest, processing, storage, and implantation of the tissue, as well as donor tissue endothelial cell count were obtained from reports made available from the Eye Bank of Canada. The adverse outcome of interest was graft detachment. Results. 71 cases were reviewed, with 14% resulting in detachment. The following time periods were compared between detachment and nondetachment groups: donor death to enucleation; enucleation to processing; duration of storage at the Eye Bank to implantation. No statistically significant differences were found (Student's t-test, ). Endothelial cell counts of donor tissue were compared between the two groups, and no statistically significant difference was found (Student's t-test, ). Conclusion. The range of processing times and endothelial cell counts in donor tissue available from the Eye Bank did not predict a change in the rate of graft dislocation in one surgeon's practice.

2019 ◽  
Vol 4 ◽  
pp. 6-6
Author(s):  
Bella J. Wolf ◽  
Ji Won Kwon ◽  
Gabriel M. Rand ◽  
Jimmy K. Lee ◽  
Patrick K. Gore ◽  
...  

2011 ◽  
Vol 04 (01) ◽  
pp. 73 ◽  
Author(s):  
Keith A Walter ◽  
Neil B Griffin ◽  
◽  

Purpose:To describe the functional characteristics of a corneal endothelium delivery instrument, EndoSaver™, and report its clinical performance in more than 250 endothelial keratoplasty surgeries with a 4mm incision.Methods:Data were assessed from 144 patients with endothelial cell failure enrolled in a prospective, interventional, non-randomized, uncontrolled trial as per an institutional-review-board-approved protocol. Subjects underwent endothelial keratoplasty performed by two experienced surgeons using the EndoSaver. Donor tissue was loaded onto the device and inserted through a 4mm incision. The authors describe their experiences using the EndoSaver when performing endothelial keratoplasty and report six-month endothelial cell counts.Results:No primary graft failures occurred with either surgeon’'s group. The mean endothelial cell loss at six months was correlated to graft thickness. Donor tissue thickness that was between 52–120μm (n=107), and 122–158μm, had endothelial cell loss of 31 and 26%, respectively. Seventy-one patients (49%) had 20/40 or better vision at 6 months. Ninety-five (66%) patients had 20/60 or better visual acuity. Five patients (3%) had a visual acuity of 20/70 or worse.Conclusions:Our report indicates that the EndoSaver is a superior option when compared to the forceps insertion technique for endothelial keratoplasty. Data indicates that between two surgeons and centers there is little variability in final endothelial cell counts at six months. The EndoSaver is the only instrument capable of a single, small incision (4mm) clear cornea surgery that requires no additional instrumentation to perform endothelial keratoplasty.


2011 ◽  
Vol 151 (3) ◽  
pp. 488-493 ◽  
Author(s):  
Ahmad Kheirkhah ◽  
Ali Izadi ◽  
Mohammad Yaser Kiarudi ◽  
Rahman Nazari ◽  
Hesam Hashemian ◽  
...  

Cornea ◽  
2010 ◽  
Vol 29 (8) ◽  
pp. 878-882 ◽  
Author(s):  
Raneen Shehadeh Mashor ◽  
Igor Kaiserman ◽  
Nikhil Kumar ◽  
Wiwan Sansanayudh ◽  
David Rootman

2013 ◽  
Vol 19 (3) ◽  
pp. 452-459 ◽  
Author(s):  
Wakako Tsuji ◽  
Hiroshi Ishiguro ◽  
Sunao Tanaka ◽  
Megumi Takeuchi ◽  
Takayuki Ueno ◽  
...  

2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.


2013 ◽  
Vol 19 (4) ◽  
pp. 399-408 ◽  
Author(s):  
Daniel L. Cooke ◽  
Hua Su ◽  
Zhengda Sun ◽  
Yi Guo ◽  
Diana Guo ◽  
...  

The absence of safe and reliable methods to harvest vascular tissue in situ limits the discovery of the underlying genetic and pathophysiological mechanisms of many vascular disorders such as aneurysms. We investigated the feasibility and comparable efficacy of endothelial cell collection using a spectrum of endovascular coils. Nine detachable coils ranging in k coefficient (0.15–0.24), diameter (4.0 mm–16.0 mm), and length (8.0 cm–47.0 cm) were tested in pigs. All coils were deployed and retrieved within the iliac artery of pigs (three coils/pig). Collected coils were evaluated under light microscopy. The total and endothelial cells collected by each coil were quantified. The nucleated cells were identified by Wright-Giemsa and DAPI stains. Endothelial and smooth muscle cells were identified by CD31 and α-smooth muscle actin antibody staining. Coils were deployed and retrieved without technical difficulty. Light microscopy demonstrated sheets of cellular material concentrated within the coil winds. All coils collected cellular material while five of nine (55.6%) coils retrieved endothelial cells. Coils collected mean endothelial cell counts of 89.0±101.6. Regression analysis demonstrated a positive correlation between increasing coil diameter and endothelial cell counts (R2 = 0.52, p = 0.029). Conventional detachable coils can be used to harvest endothelial cells. The number of endothelial cells collected by a coil positively correlated with its diameter. Given the widespread use of coils and their well-described safety profile their potential as an endovascular biopsy device would expand the availability of tissue for cellular and molecular analysis.


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