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Comparison of punching techniques for preparation of endothelial grafts for Descemet's membrane endothelial keratoplasty

Poster Details

First Author: R.Tan CANADA

Co Author(s):    P. Morales   M. Taha   E. Santiago   N. Noordeh   Y. Yang   K. Baig     

Abstract Details

Purpose:

To compare the use of a widely available dermatologic punch for preparing endothelial grafts for Descemet Membrane Endothelial Keratoplasty (DMEK), with the current standard trephine punch.

Setting:

University of Ottawa Eye Institute, Ottawa, Ontario, Canada

Methods:

This is a prospective, randomized, masked, ex-vivo paired-eye investigation. In a wet-lab setting, eleven pairs of donor corneas were harvested using the submerged cornea using backwards away (SCUBA) technique. For each pair, one cornea was prepared using a 10mm Barron punch (BP) and the other with a 10mm dermatologic Acu-punch (AP). The number of graft tears was counted for each punching technique. Also, the circularity of the grafts was evaluated though Adobe�Â�® analysis and the ease of peeling graft tissue graded using a 5-item Likert scale. The Mann-Whitney U and chi-square tests were used with significance set at p=0.05.

Results:

Results of 11 paired corneas revealed that the number of graft tears were not statistically different when using the BP (4.64 3.38) vs AP (4.46 6.15; U = 47.00, Z = 0.90, p = 0.37). Also, the circularity of the graft after using the BP (0.72�.095) and the AP (0.73�.11) were also statistically not different (U = 49.0, Z = -0.76, p = 0.45). No differences were found in the ease of peeling between the BP group and AP group (X2 = 0.277, df = 2, p = 0.871).

Conclusions:

The widely available dermatologic punch (Acu-Punch) is comparable to the standard Barron punch when used for harvesting grafts for DMEK. It may be a cheaper, widely available alternative to the standard punch and could potentially make DMEK more affordable and widespread in the future.

Financial Disclosure:

NONE

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