Factors influencing corneal predescemetic endothelial keratoplasty (PDEK) graft creation: It's all in a bubble

AIM

To assess the effect of pneumatic (air) and fluidic (transport medium) injection to the type of bubble (I, II or mixed III) and the resultant dissection of corneal endothelial grafts PDEK or DMEK.

MATERIALS AND METHODS

All grafts were obtained from Dr Agrawal Hospital's Eye Bank. Air injection was the initial preferred mode of graft harvest. If pneumatic dissection was unsuccessful after 10 tries, fluidic dissection with transport medium was tried. SPSS 23.0 was used to statistically analyse the data.

RESULTS

40 consecutive donor corneas with a mean age of 46.5 and a mean endothelial count of 2980 were analysed. Air dissection lead to the harvest of 27 endothelial grafts and fluid dissection led to the creation of 7 endothelial grafts. Statistically significant difference was found the different bubble types and the type of injection (χ² chi square=10.02, 0=0.008).

CONCLUSION

In young donors pneumatic (air) graft dissection leads to PDEK in a high proportion. This percentage is reduced when transport medium is tried after unsuccessful air injection. Injection of transport medium increases the percentage of grafts harvested but also increases the ratio of Type II and III DMEK grafts created.

[A New Way to Look Up. Solar Retinopathy Risks and Methods of Prevention Prior to the 2015 Solar Eclipse]

A solar eclipse is an impressive natural phenomenon that was last experienced in Europe in 2006. Last year, on March 20th 2015, a solar eclipse was visible in much of Europe. Solar retinopathy is a recognised potentially sight threatening condition that has been associated with direct or unprotected sun gazing. Public education has been shown to improve behaviour and attitudes that could influence the development of solar retinopathy during an eclipse. We have performed a study through newspapers prior to the 2015 solar eclipse in different European countries, in order to determine the level of public health awareness and attitudes to protection. Methods: 31 online editions of national newspapers were reviewed from six countries where the eclipse was most visible. Solar retinopathy, potential warnings, safe methods of viewing an eclipse and assessment of use and dangers of modern technologies were assessed. Results: All 25 newspapers examined mentioned the solar eclipse and risk to eyesight. Safe methods for viewing the eclipse were discussed in all newspapers. Eclipse eyeglasses were mentioned in 29 of the 31 newspapers reviewed. Children were identified as a high-risk group but advice for children viewing the eclipse varied between countries. Conclusion: Since the solar eclipse of 2006, there has been an increase in the level of education available in the media. Although the safe methods for viewing an eclipse have not changed in recent years, emerging technologies, such as camera phones and the "selfie" trend, have potentially increased the risk of eclipse-associated retinopathy.