title: Retrephination of eccentric donor graft for descemet stripping automated endothelial keratoplasty.
abstract: We describe a technique of intraoperative eccentric retrephination of Descemet stripping automated endothelial keratoplasty (DSAEK) donor graft to avoid the presence of epithelium on the graft lenticule. Trephination of the DSAEK graft may prove to be very challenging for surgeons, especially when flap diameter is small; this can result in an eccentric trephination and the presence of epithelium on the graft. Insertion of epithelium with DSAEK donor graft into the anterior chamber could result in epithelial ingrowth and downgrowth, complications that may lead to poor visual outcomes, graft detachment, and anterior chamber angle closure. A second eccentric retrephination is a simple and easy-to-perform intraoperative surgical step that could avoid the presence of corneal epithelium on the DSAEK donor graft.
authors.affiliation: Institute of Vision and Optics, Department of Medicine, University of Crete, Heraklion, Greece. kymionis@med.uoc.gr
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Vasilios F
authors.initials: VF
authors.lastname: Diakonis
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Papathanasiou
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
mesh_terms: D003315:Cornea / Q000601:surgery*; D015715:Corneal Edema / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D012086:Reoperation; D014019:Tissue Donors