International Ophthalmology

, Volume 39, Issue 10, pp 2295–2301 | Cite as

Safety analysis and results of a borosilicate glass cartridge for no-touch graft loading and injection in Descemet membrane endothelial keratoplasty

  • Annekatrin RickmannEmail author
  • Silke Wahl
  • Alisa Katsen-Globa
  • Peter Szurman
Original Paper



The aim of this study was to investigate the clinical outcome after standardized DMEK using a glass injector.


A total of 254 patients undergoing DMEK surgery using a disposable DMEK borosilicate glass cartridge system were included in this retrospective study. The mean follow-up time was 13.2 months (SD ± 8.1, range 6–36 months). The used glass cartridge system has an aperture diameter of 1.6 mm and a posterior loading orifice of 4.29 mm. Scanning electron microscopy (SEM) was used for estimation of the surface relief of the glass cartridge and comparison with a standard plastic injector cartridge.


Mean endothelial cell count of donor grafts was 2465 cells/mm2 (SD ± 199). After 6 weeks of DMEK endothelial cell count decreased by − 28.6% to 1759 cells/mm2 (SD ± 435) (Wilcoxon p = 0.001) and remained stable at the final follow-up at 1735 cells/mm2 (SD ± 442) (Wilcoxon p = 0.89). SEM showed smoother surface of the glass cartridge in comparison with a plastic cartridge.


This study showed that this simple and effective DMEK cartridge seems to be a safe and viable device for minimized graft manipulation during DMEK surgery.


DMEK Cartridge DMEK injector No-touch technique 


Compliance with ethical standards

Conflict of interest

Peter Szurman has a patent for the described device (EP2533724 B1; WO2012065602 A3). All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Eye Clinic SulzbachKnappschaft Hospital SaarSulzbachGermany
  2. 2.Fraunhofer Institute for Biomedical EngineeringSulzbachGermany
  3. 3.University Eye Clinic Tuebingen, Centre for OphthalmologyTuebingenGermany

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