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Abstract

To evaluate clinical safety and efficacy of a novel use of an ocular tissue adhesive in Descemet's Stripping (Automated) Endothelial Keratoplasty (DSAEK). Methods35 consecutive DSAEK cases were evaluated retrospectively. In group-A (n A =15) the tissue adhesive (Re Sure Adherent Ocular Bandage, Ocular Therapeutix, Inc., Bedford, MA) had been used, prior to placement of one suture, while in group-B (n B =20), only nylon sutures were used for the closure of corneal incisions. Peri-operative complications were noted. Visual Acuity, refraction and topographic cylinder, Intraocular Pressure (IOP), and endothelial cell counts (ECC) were monitored long-term for up to two years. ResultsFollow-up time was 10.5±8.5 (8 to 29) months. No case from group-A required any additional air insertion following the tissue adhesive application and no case required additional intra operative surgical manipulation for further graft centration. In group-B eighteen (out of twenty) cases required intra-operative supplemental air insertion, and four of those intra-operative repositioning of the graft. The differences in visual acuity and IOP were not statistically significant; ECC change of -16% in group-A vs. -21% was noted in group-B (statistically significant, p =0.03). Hyperopic shift was noted in both groups; cylinder reduction was noted, too, with group-A performing better. ConclusionsTissue adhesive may be a valuable adjunct in clear-cornea DSEAK by stabilizing the potential of air escape from the main incision inadvertently occurring during suture placement.