Endothelial keratoplasty: the use of viscoelastic as an aid in reattaching the dislocated graft in abnormally structured eyes.
OBJECTIVE
To explore the feasibility of reattaching the dislocated graft with viscoelastic in abnormally structured eyes after Descemet-stripping automated endothelial keratoplasty (DSAEK).


METHODS
Retrospective case series.


METHODS
Five pseudophakic bullous keratopathy cases (5 eyes) with a history of vitrectomy and/or iris-lens diaphragm injury.


METHODS
After DSAEK, graft dislocation occurred in each of the 5 cases (5 eyes). We attempted to fill the anterior chamber (AC) with an air bubble to push up the dislocated graft, but this was not successful. We then injected balanced salt solution into the vitreous body to obtain normal intraocular pressure (IOP) and injected a small amount of viscoelastic (Healon GV) to support the AC. Next, we injected an air bubble into the AC.


METHODS
The position of the grafts was checked with a slit lamp and anterior segment optical coherence tomography (AS-OCT). The IOP was observed with Goldmann tonometer. The best visual acuity was checked.


RESULTS
As observed through the slit lamp and AS-OCT, the grafts reattached well in all patients. The IOP was normal in all patients except one, who had high IOP 1 month postoperatively. After receiving drug treatment, the patient's IOP returned to normal. The grafts had slight edema on postoperative day 1, but became transparent between days 5 and 8.


CONCLUSIONS
Viscoelastic aided in the reattachment of the dislocated graft in eyes with a history of vitrectomy and/or iris-lens diaphragm injury. The presence of viscoelastic in the AC in the early period of post-DSAEK was well tolerated in this small series.
Peng
Rong-Mei
RM
The Peking University Third Hospital, Peking University Eye Center, Beijing, China.
Hao
Yan-Sheng
YS
Chen
Hui-Jin
HJ
Sun
Yan-Xiu
YX
Hong
Jing
J
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects / Q000473:pathology; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery; D004728:Endothelium, Corneal / Q000473:pathology / Q000637:transplantation*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007429:Intraocular Pressure / Q000502:physiology; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D055675:Viscosupplements / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D055675:Viscosupplements; D006820:Hyaluronic Acid