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Federico Luengo Gimeno, Donald D T. Tan, Myint Hla Htoon, Jodhbir S. Mehta; Effects Of Air Tamponade In DSAEK. Intraoperative Follow-up. Invest. Ophthalmol. Vis. Sci. 2011;52(14):765. doi: https://doi.org/.
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To evaluate the intraoperative effects of air tamponade in Descement automated stripping endothelial keratoplasty (DSAEK) using a handheld Spectral-domain optical coherence tomography (OCT).
Prospective study on 10 eyes (10 patients) treated with DSAEK because of pseudophakic bullous keratopathy (n=4) or Fuch’s endothelial dystrophy (n=6). Measurements of donor corneas were done pre and post-automated cutting. During the surgery, measurements of donor and recipient corneas as well as donor-host interface were done pre air tamponade, post fluid milking, and 6 and 10 minutes after air tamponade. All surgeries were done using Tan DSAEK endoglide. A non parametric analysis was performed.
All surgeries were done without complications. No graft disolocations occurred. The mean size of the donor corneas pre and post-automated cutting was 447.80um (SD 44.63) and 133.24um (47.54). After Tan DSAEK Endoglide donor insertion, mean pre air tamponade measurements were 230.60um (SD 43.66) for the donor, 600.29um (SD 63.67) for the recipient and 495um (SD 49.50) for the donor-host interface. After air tamponade the mean values were 275um (SD 74.70) (donor), 586.60um (68.86) (recipient) and 69.00um (SD 48.54) (interface). After 6 and 10 minutes of air tamponade, the mean meassurement of the graft were 286.67um (SD 80.13) and 212.00um (SD 68.97), the recipient cornea 586.00um (SD 78.39) and 581.75um (SD 56.31) and the interface between both was 33.00um (SD 18.18) at 6 minutes and 2.33um (SD 2.00) at 10 minutes.
The graft and recipient during DSAEK undergo a variation in thickness following TAN endoglide insertion. The first 6 minutes following air tamponade after the fluid milking play an important role in preventing graft dislocation. The use of an intraoperative OCT helps the surgeon to corroborate the attachment of the graft.
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