Bagel sign and how to avoid it in DMEK surgery.

Autor:	Pagano L; St Paul Eye Unit, Liverpool University Hospitals, Liverpool, UK.; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy., Alfaqawi F; St Paul Eye Unit, Liverpool University Hospitals, Liverpool, UK., Borgia A; St Paul Eye Unit, Liverpool University Hospitals, Liverpool, UK., Aiello F; Ophthalmology Unit, Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy., Airaldi M; Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italia.; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy., Kaye SB; St Paul Eye Unit, Liverpool University Hospitals, Liverpool, UK., Romano V; Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italia.; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy.
Jazyk:	angličtina
Zdroj:	European journal of ophthalmology [Eur J Ophthalmol] 2024 Nov 15, pp. 11206721241299473. Date of Electronic Publication: 2024 Nov 15.
DOI:	10.1177/11206721241299473
Abstrakt:	Purpose: To provide a detailed description of the recommended surgical technique for gas injection during Descemet's Membrane Endothelial Keratoplasty (DMEK) surgery and highlight intraoperative sign that emerged in case of fluid retention in the interface. Methods: Gas injection recommended surgical technique is 2 steps procedure using a 1 ml syringe: the first step consists in injecting centrally to the graft and very slowly a bubble of gas smaller than the DMEK graft size, the second step, after checking the absence of fluid interface (no bagel sign), consists in enlarging the gas bubble to the desired filling. Results: Bagel sign allows surgeons to look for interface fluid and correct for potential issues leading to graft detachment. The recommended surgical technique for gas injection also may help to prevent fluid retention in the interface and reduce the risk of graft detachment. Conclusion: Detecting a fluid interface retention at the end of DMEK surgery through iOCT or simply looking for the bagel sign may help to prevent post-operative complications. Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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