A simple rescue maneuver for unfolding and centering a tightly rolled graft in Descemet membrane endothelial keratoplasty

نویسندگان

  • Konstantinos Droutsas
  • Thomas Bertelmann
  • Frank M Schroeder
  • Dimitrios Papaconstantinou
  • Walter Sekundo
چکیده

A 74-year-old man underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial decompensation due to Fuchs endothelial dystrophy. After descemetorhexis, the DMEK graft was inserted into the anterior chamber. However, unfolding of the graft was not possible as the graft was very tightly rolled together and the anterior chamber deep. After placing a 30G-cannula connected to an air-filled syringe inside the roll's lumen, a small air bubble was injected, which allowed the roll to open up, until it assumed a "taco" configuration around the bubble. Then, the graft was centered by pressing the posterior part of the roll against, and sweeping it over the iris. In the present case a "tight" DMEK roll was successfully unfolded by injection of a single air bubble into the roll's lumen and centered by a "sweeping" the partialy unfolded graft over the iris. This technique allowed a controlled unfolding and centering of the DMEK graft with limited trauma to the donor endothelium and may be applied in cases where other less traumatic maneuvers are not successful.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Intraoperative OCT-Assisted DMEK: 14 Consecutive Cases.

PURPOSE To describe the utility of a new intraoperative optical coherence tomographer (OCT) to evaluate endothelio-Descemet graft orientation during Descemet membrane endothelial keratoplasty (DMEK) procedures. METHODS Prospective, observational, and single-center pilot case series including 14 eyes of 14 patients consecutively scheduled for DMEK surgery. After injecting the graft into the an...

متن کامل

Determinants of visual quality after endothelial keratoplasty.

Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, w...

متن کامل

Eventual Endothelial Failure After Initial Corneal Clearing After a Detached Endothelial Graft in Fuchs Dystrophy

mated Bowman layer preparation with a 90to 100-mm-thick donor lamella of anterior stroma (instead of an 8to 12-mm-thick isolated Bowman layer graft). In our experience, the presence of donor stroma seems to degrade the optical quality of the transplanted cornea (as Descemet stripping endothelial keratoplasty/Descemet stripping automated endothelial keratoplasty grafts containing donor stroma ma...

متن کامل

Chandelier Illumination for Descemet Membrane Endothelial Keratoplasty

PURPOSE To describe a simple technique that uses posterior chandelier illumination during Descemet membrane endothelial keratoplasty in cases of severe bullous keratopathy (BK). METHODS Five eyes of 4 patients with advanced BK undergoing Descemet membrane endothelial keratoplasty were retrospectively analyzed. The pupil of the host eye was not treated with mydriatic or miotic agents. The chan...

متن کامل

Descemet Membrane Endothelial Keratoplasty as a Secondary Approach After Failure of Penetrating Keratoplasty.

OBJECTIVES To investigate visual outcome and postoperative complications in patients undergoing Descemet membrane endothelial keratoplasty with graft failure after penetrating keratoplasty. MATERIALS AND METHODS A retrospective analysis was performed with 5 patients who underwent Descemet membrane endothelial keratoplasty after failed penetrating keratoplasty. Intraoperative and postoperative...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 8  شماره 

صفحات  -

تاریخ انتشار 2014