Case Reports in Ophthalmology (Jun 2012)

No-Touch Technique and a New Donor Adjuster for Descemet’s Stripping Automated Endothelial Keratoplasty

  • Akira Kobayashi,
  • Hideaki Yokogawa,
  • Kazuhisa Sugiyama

DOI
https://doi.org/10.1159/000339835
Journal volume & issue
Vol. 3, no. 2
pp. 214 – 220

Abstract

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Purpose: One difficulty with Descemet’s stripping automated endothelial keratoplasty (DSAEK) is air management during surgery and donor endothelial lamella centering. We evaluated the no-touch technique for donor centering and the use of a newly developed DSAEK donor adjuster. Methods: We evaluated the records of 12 consecutive patients (mean age 75.3 years) with bullous keratopathy who had undergone DSAEK. In all cases, the no-touch technique was attempted first. When the no-touch technique failed, a DSAEK donor adjuster with a 30-gauge cannula resembling a curved reverse Sinskey hook was used for donor centering. The adjuster allows air injection during donor centering. Results: The no-touch technique using simple corneal surface massage to center the graft was successful in 4 cases (33.3%), while 4 cases required ocular tilting (33.3%) in addition to corneal surface massage. The no-touch technique was ineffective in 4 cases (33.3%), but the donor adjuster was used successfully and easily for these patients. Comparing the endothelial cell loss rate between the no-touch technique group and the donor adjuster group, there was no significant difference at 6 months. Conclusions: The no-touch technique was useful for better control of DSAEK donor centering in most cases. When the no-touch technique was ineffective, the DSAEK donor adjuster was uniformly successful.

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