May 2006
Volume 47, Issue 13
ARVO Annual Meeting Abstract  |   May 2006
Endothelial Keratoplasty (DLEK and DSEK): 3 Steps to Prevent Dislocations
Author Affiliations & Notes
  • M.A. Terry
    Devers Eye Institute, Portland, OR
    Oregon Lions Sight and Hearing Foundation, Portland, OR
  • K. Hoar
    Devers Eye Institute, Portland, OR
  • J. Wall
    Oregon Lions Sight and Hearing Foundation, Portland, OR
  • Footnotes
    Commercial Relationships  M.A. Terry, Patent on surgical instruments devloped for Bausch and Laumb, P; K. Hoar, None; J. Wall, None.
  • Footnotes
    Support  Oregon Lions Sight and Hearing Foundation
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 2376. doi:
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      M.A. Terry, K. Hoar, J. Wall; Endothelial Keratoplasty (DLEK and DSEK): 3 Steps to Prevent Dislocations . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2376.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : The reported dislocation rate in DLEK is 4% and in DSEK/DSAEK is 10–25%. Based on our prior electron microscopy studies of interface morphology we added peripheral bed scraping to our usual surgical regimen of DSEK/DSAEK in order to reduce or eliminate donor tissue dislocation.

Methods: : 30 consecutive eyes in a prospective study underwent DSEK/DSAEK surgery for endothelial failure. The 3 steps utilized to prevent dislocation were: 1.) Peripheral recipient bed scraping prior to donor insertion, 2.) Surface sweeping with compression to remove interface fluid, 3.) and 10 minutes of an undisturbed anterior chamber air bubble intraoperatively. No incisions to drain interface fluid were utilized and a minimal residual air bubble was left behind with the patient kept supine for 1 hour post–op.

Results: : There were 0 dislocations in this series. Both the central and peripheral interface post–operatively were clear.

Conclusions: : Intra–operative recipient bed scraping combined with compressive removal of interface fluid substantially eliminates donor dislocation in endothelial keratoplasty, without the need for post–operative air bubble manipulations or corneal drainage incisions.

Keywords: transplantation • cornea: endothelium • cornea: clinical science 

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