Safety analysis and results of a borosilicate glass cartridge for no-touch graft loading and injection in Descemet membrane endothelial keratoplasty

PurposeThe aim of this study was to investigate the clinical outcome after standardized DMEK using a glass injector.MethodsA total of 254 patients undergoing DMEK surgery using a disposable DMEK borosilicate glass cartridge system were included in this retrospective study. The mean follow-up time was 13.2 months (SD8.1, range 6-36 months). The used glass cartridge system has an aperture diameter of 1.6 mm and a posterior loading orifice of 4.29 mm. Scanning electron microscopy (SEM) was used for estimation of the surface relief of the glass cartridge and comparison with a standard plastic injector cartridge.ResultsMean endothelial cell count of donor grafts was 2465 cells/mm(2) (SD +/- 199). After 6 weeks of DMEK endothelial cell count decreased by -28.6% to 1759 cells/mm(2) (SD +/- 435) (Wilcoxon p=0.001) and remained stable at the final follow-up at 1735 cells/mm(2) (SD +/- 442) (Wilcoxon p=0.89). SEM showed smoother surface of the glass cartridge in comparison with a plastic cartridge.Conclusionp id=ParThis study showed that this simple and effective DMEK cartridge seems to be a safe and viable device for minimized graft manipulation during DMEK surgery.