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The Endothelial Safety of Using a Gentian Violet Dry-Ink “S” Stamp for Precut Corneal Tissue

Stoeger, Christopher BA; Holiman, Jeff BS; Davis-Boozer, David MPH; Terry, Mark A. MD

doi: 10.1097/ICO.0b013e31823f7571
Basic Investigation

Purpose: To determine the endothelium damage resulting from the application of “dry” gentian violet (GV) stromal markings on corneas precut for Descemet stripping automated endothelial keratoplasty (DSAEK) using a Moria “S” Stamp.

Methods: Five precut corneas had the stromal graft bed marked with GV using the Moria “S” stamp and 6 precut corneas were left unmarked as controls. After applying the ink to the stamp, care was taken to allow the alcohol carrier to dry for 10 seconds before applying the dry dye to the stromal surface. Tissue was then trephinated and stained with calcein AM to assess endothelial viability. Grafts were photographed and digital pixel planometry, using an established analysis technique, was used to compare the damage between the control and experimental groups.

Results: The mean percent cell damage of corneas treated with GV “S” stamp (n = 5) was 8.6% (range 4.4–12.9), and it was 8.1% (range 3.9–15.1) in the DSAEK control set (n = 6). Median percent cell damage was 6.7% among GV-treated corneas and 7.4% among control corneas. The distributions were not significantly different between groups (Mann–Whitney U test = 15.0, two-tailed P = 1.0). Moreover, no “S” pattern of damage was seen in any study eye.

Conclusions: There were no significant differences in endothelial damage between the 2 groups. GV stromal markings may be applied without undue damage to the endothelium using the dry-ink technique described.

*Lions VisionGift, Portland, OR

Devers Eye Institute, Portland, OR.

Reprints: Christopher Stoeger, Lions VisionGift, 2201 SE 11th Avenue, Portland, OR 97214 (e-mail:

Supported by Lions VisionGift Research, Portland, Oregon.

Dr Terry has received royalties from Bausch and Lomb Surgical (St Louis, MO) for EK instruments which he designed. Dr Terry is on the medical advisory board of Optovue Corporation. None of the authors has proprietary interests or has received financial compensation from Moria Corp.

Received August 16, 2011

Accepted October 17, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.