Endoart Artificial Endothelial Replacement Membrane Implant For Treating Corneal Edema After Failed Penetrating Keraotplasty
Published 2025 - 43rd Congress of the ESCRS
Reference: PP25.11 | Type: Free paper | DOI: 10.82333/3qe3-0z73
Authors: Umberto Camellin 1 , Gianluigi Latino* 2 , Silvia Rimondi 2 , Giuseppe Righetti 3 , Piero Ceruti 3 , Massimo Camellin 2
1Sekal Microchirurgia Rovigo,Rovigo,Italy;Ophthalmology,Legnago Hospital,Legnago,Italy, 2Sekal Microchirurgia Rovigo,Rovigo,Italy, 3Ophthalmology,Legnago Hospital,Legnago,Italy
Purpose
To report the outcomes of a novel artificial endothelial replacement membrane implant for treating corneal edema in patients with multiple prior graft rejections, making them less suitable for repeat live donor keratoplasty.
Setting
This study was conducted at the Ophthalmology Department of Hadassah Medical Center, a tertiary care facility specializing in advanced corneal and anterior segment surgeries.
Methods
Nine patients with chronic corneal edema and a history of multiple graft rejections underwent implantation of an artificial endothelial replacement membrane (EndoArt, EyeYon Medical, Israel) in eyes after penetrating keratoplasty. The implant was secured to the posterior corneal surface using an air–gas bubble and CU-5 nylon sutures. Outcome measures included corrected distance visual acuity (logMAR), central corneal thickness, and device-related complications.
Results
Nine eyes of nine patients underwent EndoArt implantation. At 3–6 months postoperatively, the membrane was well-centered and adherent, with improved corneal transparency in all patients. Corrected distance visual acuity (logMAR) improved from 2.3 to 1.0, and central corneal thickness decreased from 740 µm to 580 µm. One patient developed infectious keratitis, and another required reimplantation. Most patients needed multiple air–gas bubble injections and sutures for adhesion. No severe complications occurred, and all patients reported reduced ocular pain.
Conclusions
Synthetic endothelial replacement membrane implantation improves central corneal transparency and visual acuity in patients with failed PK and a history of multiple graft rejections, making them less suitable for repeat live donor keratoplasty. No significant implant-related adverse events occurred after surgery. This study, conducted at the Hadassah Ophthalmology Department, demonstrates the potential of this novel technique as a viable alternative for managing corneal edema in complex, high-risk cases.