Artificial Endothelial Device (Endoart): One-Year Follow-Up

To report the long-term outcomes of a novel artificial endothelial device (EndoArt) for treating chronic corneal edema in complex cases.

Fernández-Vega University Institute, Oviedo, España

Patients with poor prognosis for graft survival and chronic corneal edema underwent removal of the Descemet membrane or previous endothelial graft and implantation of an artificial endothelial replacement membrane (EndoArt, EyeYon Medical, Israel). The device was secured to the posterior corneal surface using an air–gas bubble and a nylon suture. Main outcome measures included central corneal thickness, corrected distance visual acuity, device related complications and ocular discomfort.

20 eyes of 19 patients underwent EndoArt implantation. Central corneal transparency improved in 90% of the patients. Central corneal thickness significantly decreased from a mean of 890.5±169 μm preoperatively to 581.4±109 μm (p<0.01). Marginal improvement in visual acuity was obtained due to severe ocular comorbidities and chronic stromal fibrosis but 31.3% of eyes gained lines of vision and no one lost lines. No severe device-related complications developed after surgery, although 30% of the  patients required 1 air/gas bubble injection to achieve implant adhesión and two patients suffered a severe corneal thinning that was resolved by patching those eyes.  All changes occurred before month 3 and remained stable over the first year.

EndoArt implantation improves central thickness and corneal transparency in patients with bullous keratopathy and poor prognosis for a endothelial or penetrating keratoplasty. No significant implant-related adverse events occurred after surgery.