Descemet-stripping automated endothelial keratoplasty with a donor tissue injector

We describe the use of the Endoserter, a single-use disposable donor tissue injector for donor insertion during Descemet-stripping automated endothelial keratoplasty. Donor tissue is transferred onto the orange platform of the injector with the endothelial surface up, and the platform retracted into the donor tissue injector. The injector is inverted and the tip inserted into the anterior chamber through a 4.1 mm clear corneal incision. Continuous irrigation through the injector maintains the anterior chamber as the platform with the donor tissue is unsheathed in the eye. As the platform is unsheathed, the donor tissue is released from the platform and spontaneously unfolds with the endothelial surface in the correct orientation. In a retrospective review of our first year of use (71 eyes), we found that donor insertion with this injector was uneventful even during the initial learning curve and was compatible with a low complication rate and good graft survival at 6 months.

Dr. Kim is a consultant to Ocular Systems, Inc. Dr. Khor has no financial or proprietary interest in any material or method mentioned.