title: A modified technique for descemet membrane stripping automated endothelial keratoplasty to minimize endothelial cell loss.
abstract: In an attempt to enhance postoperative survival of donor endothelium, the conventional technique for Descemet membrane stripping automated endothelial keratoplasty (DSAEK) was modified using the prototype of a glide specially designed to facilitate graft delivery and minimize surgical trauma. Instead of using the so-called taco technique, the Busin glide is loaded with the donor lamella, and a microincision forceps is inserted into a temporal side entry and passed across the anterior chamber, exiting through a nasal clear cornea tunnel to grab the graft and drag it into the eye. In 10 patients who underwent DSAEK, mean (SD) postoperative endothelial cell loss was 20.0% (2.6%) at 6 months, 23.5% (2.8%) at 12 months, and 26.4% (2.7%) at 18 to 24 months. Reduced trauma to the graft using our modified technique limits endothelial cell loss after DSAEK to the level recorded after conventional penetrating keratoplasty (PK).
authors.affiliation: Department of Ophthalmology, Villa Serena Hospital, Via Sisa 33, 47100 Forlì, Italy. mbusin@yahoo.com
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
authors.forename: Priya R
authors.initials: PR
authors.lastname: Bhatt
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scorcia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002470:Cell Survival; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing