RUMEX International Co developed a set of instruments for corneal transplantation in cooperation with Dr. Abdullayev, MD, MBA, CEBT, Manager of Clinical Development and Innovations at Lions Eye Institute for Transplant & Research, Inc., USA.
Dr. Abdullayev has been involved in Eye Banking community since 1996 and has many scientific publications on new techniques and procedures of Eye Banking, corneal transplantation and preservation.
We’re running a column to share his rich experience and knowledge. This information will be interesting not only for doctors, specializing in corneal surgery, but to everyone who is concerned with the subject of transplantation.
- Dr. Abdullayev, please tell us about the trends of posterior keratoplasty?
Nowadays, the amount of penetrating keratoplasty decreases while the amount of posterior endothelial keratoplasty increases.
According to Annual report of Eye Bank Association of America, the number of penetrating grafts performed in the U.S. using intermediate-term preservation increased slightly this year from 17,347 to 17,409 but had decreased in each of the previous 13 years from a high of 42,063 in 2005 to a low of 17,347 in 2018. In the past 10 years, EK procedures increased from 1,308 in 2010 to 30,650 in 2019. The number of corneas used domestically for EK has increased every year since tracking started in 2005 and surpassed PK in 2012. EK has been the most common keratoplasty procedure performed in the U.S. since 2012. The number of EK procedures (which includes both DSAEK and DMEK) increased 1% in 2019 to 30,650 from 30,336 in 2018.
- Not so long ago you’ve invented the innovative DSAEK graft injection method. Please let us know more about it.
Forceps method and pull in methods (require additional unloading forceps) are current techniques in the world for delivery of DSAEK graft into recipient eye. They cannot be preloaded in advance, require a large, usually between 4 to 5 mm incision, anterior chamber maintainer, resulting in significant endothelial cells loss up to 30-40%, and require at least 3 closing sutures. My innovative DSAEK graft injection method is a LEITR DSAEK 3.0 (just presented at the Cornea & Eye Banking Forum 2020 on November 7th). It is a novel carrier and technique for delivering by injection of an advance eye bank preloaded DSAEK grafts through smaller wound.
Primary advantages of LEITR DSAEK 3.0 are:
- Less invasive. Requires small 3.2-3.4mm incision (only 1 closing suture is required)
- Allows delivery of DSAEK grafts into anterior chamber by fluid injection - no-touch delivery
- Closed system advantages:
- no anterior chamber maintainer is required
- deepens AC chamber
- eases graft opening
- low, only up to 5% endothelial cells loss during transport and transplant