Descemet-stripping automated endothelial keratoplasty: insertion using a novel 40/60 underfold technique for preservation of donor endothelium

Cornea
Edwin S ChenStephen D McLeod

Abstract

To describe a technique for insertion of an asymmetrically folded donor graft to minimize endothelial damage during Descemet-stripping automated endothelial keratoplasty. The tissue is folded in a 40/60 underfold rather than the commonly used 60/40 overfold. It is then grasped with the insertion forceps by using a prone hand position. The hand is rotated clockwise until it is supine, bringing the 60% side of the fold anteriorly, and then the tissue is inserted into the anterior chamber. In 112 eyes, conventional 60/40 overfold insertion technique resulted in a 36% loss in endothelial cell density at 6 months. In 36 eyes, the new 40/60 underfold technique results in a 26% cell loss. This difference of 10% was statistically significant (P = 0.001). This simple modification to a commonly used folding technique reduces trauma to the exposed peripheral endothelium in a 60/40 overfolded "taco," which is due to contact with the donor trephine block or other surface. It is a slight modification to a commonly used technique for graft insertion and can be easily implemented to reduce postoperative endothelial cell loss.

References

Mar 24, 1999·American Journal of Ophthalmology·G R MellesP S Binder
Mar 29, 2003·Journal of Cataract and Refractive Surgery·Thomas John
Apr 16, 2004·Cornea·Gerrit R J MellesCarla P Nieuwendaal
Feb 7, 2006·American Journal of Ophthalmology·Rajesh Fogla, Prema Padmanabhan
Nov 15, 2006·Cornea·Gerrit R J Melles
Nov 15, 2006·Cornea·Mark S Gorovoy
Dec 13, 2006·Ophthalmology·Steven B Koenig, Douglas J Covert
Feb 6, 2007·Journal of Cataract and Refractive Surgery·Steven B KoenigDavid M Meisler
Jun 27, 2007·Cornea·Michael HyamsDavid S Rootman

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Citations

Mar 9, 2013·International Ophthalmology Clinics·Julia C TalajicMark A Terry
Oct 18, 2013·The British Journal of Ophthalmology·Anders Ivarsen, Jesper Hjortdal
May 7, 2009·Current Opinion in Ophthalmology·Isabel DapenaGerrit R J Melles
May 15, 2010·Current Opinion in Ophthalmology·Neelofar Ghaznawi, Edwin S Chen
Sep 20, 2012·Acta Ophthalmologica·Marit Saethre, Liv Drolsum
Aug 1, 2020·Progress in Retinal and Eye Research·Michael P FautschAlice E Davidson

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