Optimizing pre-Descemet endothelial keratoplasty technique

• Published in: Journal of cataract and refractive surgery Vol. 46; no. 5; pp. 667 - 674
• Main Authors: Ross, Andrew R, Said, Dalia G, Colabelli Gisoldi, Rossella A M, Nubile, Mario, El-Amin, Abdalla, Gabr, Ahmed F, Abd Ed-Moniem, Mohamed, Mencucci, Rita, Pocobelli, Augusto, Mastropasqua, Leonardo, Dua, Harminder S
• Format: Journal Article
• Language: English
• Published: United States 01.05.2020
• Subjects: Descemet Stripping Endothelial Keratoplasty - methods; Dissection; Endotamponade - methods; Eye Banks - methods; Fuchs' Endothelial Dystrophy - surgery; Humans; Tissue and Organ Harvesting - methods; Tissue Donors
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1097/j.jcrs.0000000000000157

Pre-Descemet endothelial keratoplasty (PDEK) is an alternative technique to Descemet membrane endothelial keratoplasty (DMEK). The preparation of PDEK tissue by pneumatic dissection is simple and reproducible. The PDEK clamp helps to consistently obtain a type 1 big bubble. The mean size of type 1 big bubble is 7.255 ± 0.535 × 6.745 ± 0.668 mm. The volume of air required to obtain type 1 big bubble is 0.14 to 0.37 mL. Dissection of PDEK tissue can be achieved by trephination or manual excision. Insertion of tissue into the recipient eye can be by injection or pulling. Unfolding techniques used for PDEK are similar to those used in DMEK. Unlike DMEK, PDEK tissue is easier to handle and unscroll and allows use of younger donors. It could help surgeons converting to endothelial keratoplasty, with significant advantages in preparation, handling, and unscrolling in the eye.