Eye surgeons will soon have a new surgical tool to help make a complicated eye surgery less labor intensive while providing significant advantages for corneal transplant patients, as a result of an invention by a Wake Forest University Baptist Medical Center physician.
The new surgical tool, called the EndoSaver Corneal Endothelium Delivery Instrument, is the brainchild of ophthalmologist Keith A. Walter, M.D. Having done hundreds of Descemet's Stripping Endothelial Keratoplasty (DSEK) surgeries, Walter knew he needed a better way of inserting donor endothelial tissue. DSEK is a corneal transplant procedure where surgeons remove only the diseased innermost layer of a host cornea and replace it with healthy cornea tissue from a donor.
"The purpose of the EndoSaver is to make it easier for eye surgeons to insert the living donor tissue without damaging the tissue or crushing the cells," said Walter, an associate professor of ophthalmology at Wake Forest University Eye Center, part of Wake Forest Baptist. "Sparing injury to the fragile button of tissue during this procedure is a key part of patients' quicker visual recovery and provides better long-term results."
Traditionally, eye surgeons use forceps to grasp and fold the donor tissue, insert the tissue into the patient's eye through a 5- to 6-millimeter incision and then unfold the tissue, while attempting to limit damage to the tissue and cells.
With the new device, the donor's tissue layer is rolled up inside itself, similar to a cinnamon roll, and placed inside a spoon-shaped protective sheath. It is then inserted into the patient's eye through a smaller, 4-millimeter incision. "While turning the knob to remove the protective casing, the tissue layer unrolls itself into position as fluid maintains space to accomplish this," said Walter.
Many patients will benefit from use of this device, explained Walter, because the damage to the tissue is limited. It also results in a smaller wound, fewer sutures, fewer problems with post-operative astigmatism, less pain and a quicker visual recovery overall.