Anterior Segment Cornea
keratoplasty. The data indicate that between two surgeons and centers there is little variability in final endothelial cell counts at six months. Visual outcomes were also comparable to those in other reports.5
The EndoSaver is the only instrument capable of small-incision clear cornea surgery that requires no additional instrumentation. The advantages of topical EndoSaver endothelial keratoplasty include a smaller incision and no needle for retrobulbar block, thereby eliminating the risk of hemorrhage or globe perforation. Efficiency and cost savings are accomplished because there is no need for sutures, conjunctival incision, or cautery. Accordingly, EndoSaver use during endothelial keratoplasty results in reduced surgical risks and decreased operating room costs. We
1. Eye Bank Association of America, 2009 Eye Banking Statistical Report, Washington, DC: Eye Bank Association of America; 2009.
2. Baratz KH, Tosakulwong N, Ryu E, et al., E2-2 protein and Fuchs corneal dystrophy, N Engl J Med, 2010;363:1016–24.
3. Afshari NA, Pittard AB, Siddiqui A, Klingworth GK, Clinical study
calculate that the price of EndoSaver is easily offset by elimination of these materials and their approximate cost: sutures ($30); disposable cautery ($20); anterior chamber maintainer ($32); and reduced operating room time ($200): total: $282. In addition, if the descemetorhexis is accomplished under air, the cost of a viscoelastic ($175) and irrigation– aspiration cannula (such as Simcoe, $40) can be added to the savings. EndoSaver use results in total savings of approximately $500 compared with the costs of forceps insertion. The authors have been impressed by the device's ability to simplify the surgical procedure, accurately deliver and place tissue through a small wound, and its integral irrigation to maintain a deep chamber. A comparison of EndoSaver with other techniques is presented in Table 2. n
of Fuchs corneal endothelial dystrophy leading to penetrating keratoplasty: a 30-year experience, Arch Ophthalmol, 2006;124:777–80.
4. Allan BD, Terry MA, Price FW Jr, et al., Corneal transplant rejection rate and severity after endothelial keratoplasty, Cornea, 2007;26:1039–42.
5. Neff KD, Biber JM, Holland EJ, Comparison of central corneal graft thickness to visual acuity outcomes in endothelial keratoplasty, Cornea, 2010 Oct 28 (Epub ahead of print).
6. Terry MA, Saad HA, Shamie N, et al., Endothelial keratoplasty: the influence of insertion techniques and incision size on donor endothelial survival, Cornea, 2009;28:24–31.
76
US OPHTHALMIC REVIEW
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116