title: Presoaking donor corneas reduces graft detachment rates in descemet stripping endothelial keratoplasty.
abstract: OBJECTIVE
  To present a novel method of reducing rates of graft detachment, the most common postoperative complication of Descemet stripping endothelial keratoplasty (DSEK).
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Eighty-three consecutive patients undergoing DSEK for endothelial dystrophy were studied. DSEK was performed in 103 eyes by 2 surgeons (J.D.G. and W.J.S.) at one institution before (n = 83) and after (n = 20) presoaking donor grafts in balanced salt solution (BSS) Plus (Alcon, Fort Worth, Texas, USA). No significant change in the frequency of using other techniques was made during this time. Incidents of tissue detachment after surgery were recorded.
  
  
  RESULTS
  Of 83 consecutive DSEK procedures carried out before presoaking the donor tissue in BSS Plus, detachment occurred in 25 (30%). After presoaking, the detachment rate was reduced significantly to 0 (0%) of 20 (P = .0019).
  
  
  CONCLUSIONS
  Patients undergoing DSEK experienced a significant decrease in rates of graft detachment after adoption of this new technique. The results suggest that presoaking donor tissue in BSS Plus lowers the detachment rate of DSEK grafts.
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: Jimmy K
authors.initials: JK
authors.lastname: Lee
authors.forename: Allen O
authors.initials: AO
authors.lastname: Eghrari
authors.forename: Neel R
authors.initials: NR
authors.lastname: Desai
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Stark
authors.forename: John D
authors.initials: JD
authors.lastname: Gottsch
mesh_terms: D001639:Bicarbonates / Q000494:pharmacology; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation; D003886:Descemet Membrane / Q000601:surgery*; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000187:drug effects / Q000637:transplantation*; D005978:Glutathione / Q000494:pharmacology; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D009883:Ophthalmic Solutions / Q000494:pharmacology; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013048:Specimen Handling; D014019:Tissue Donors
chemical_list: D001639:Bicarbonates; D004338:Drug Combinations; D009883:Ophthalmic Solutions; C013003:glutathione-bicarbonate-Ringer solution; D005978:Glutathione