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M. Inoue, H. Eguchi, T. Katome, S. Matsushita, Y. Ogi, H. Shiota; A New Technique for Corneal Endothelial Graft Insertion With Ciliary Sulcus Fixation Suture in DSEK Cases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1944. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe a new surgical technique for corneal endothelial graft insertion into the anterior chamber in DSEK (Descemet’s stripping with endothelial keratoplasty) cases.
Three eyes of three cases underwent DSEK using a new technique for endothelial graft insertion with double armed 10-0 prolene that was developed originally for IOL ciliary sulcus fixation (CSF) suture. In all cases, endothelial grafts were prepared by punching pre-cut donor corneas with 7.5 to 9.0 diameter trephine. After holding the endothelial graft over with the endothelial side inward, a stitch was putted on the stroma with a curved needle and another side straight needle was pulled into the anterior chamber. The graft was positioned by pulling the straight needle without any mechanical trauma to the endothelial side and by filling the anterior chamber with air injection. No troubles related with CSF suture occurred during surgeries. In one case that had a penetrating keratoplasty previously, graft reattaching was needed postoperatively because the donor tissue was not well adherent at the host-graft interface. At one year, grafts are well positioned and central endothelial cell losses are less than 20% in another two cases.
Our new technique for DSEK without any special instrument might be very safe and has minimal damage to endothelial graft.
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