New graft inserter for descemet stripping automated endothelial keratoplasty.

Purpose: The aim of this study was to introduce a newly developed graft inserter for Descemet stripping automated endothelial keratoplasty, which can be readily used with 1 hand, and to examine endothelial cell loss (ECL) after graft insertion using this new inserter in an ex vivo rabbit model.

Methods: Rabbit corneal grafts (∼150 μm) were prepared by using a femtosecond laser. The grafts were inserted into an artificial anterior chamber by the pull-through technique using a Busin glide or the push-out technique using our new inserter. ECL was evaluated by means of trypan blue and alizarin red S staining. Grafts that were not injected served as a control group.

Results: The mean percentages of ECL area in the control, Busin glide, and new inserter groups were 18.7 ± 1.79%, 25.4 ± 2.32%, and 24.7 ± 1.56%, respectively. The mean percentages of the ECL area in both the Busin glide group and new inserter groups were significantly greater than that in the control group (P = 0.001). There was no statistically significant difference between the Busin glide group and the new inserter group.

Conclusions: Our new inserter may provide a favorable option for donor tissue insertion in Descemet stripping automated endothelial keratoplasty procedures.