Air Pump–Assisted Graft Centration, Graft Edge Unfolding, and Graft Uncreasing in Young Donor Graft Pre-Descemet Endothelial Keratoplasty
| Autor: | Soosan Jacob, Smita Narasimhan, Amar Agarwal, Athiya Agarwal, A I Saijimol |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Descemet membrane Fuchs Endothelial Dystrophy Visual Acuity Corneal Endothelial Cell Loss 03 medical and health sciences 0302 clinical medicine Donor graft Ophthalmology medicine Humans Descemet Membrane Infusion Pumps business.industry Air Fuchs' Endothelial Dystrophy Graft Survival Centration Tissue Donors surgical procedures operative Descemet Stripping Endothelial Keratoplasty 030221 ophthalmology & optometry Graft survival business 030217 neurology & neurosurgery |
| Zdroj: | Cornea. 36:1009-1013 |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000001225 |
| Popis: | To assess an air pump-assisted technique for graft centration, graft edge unfolding, and graft uncreasing while performing pre-Descemet endothelial keratoplasty (PDEK) using young donor grafts.Continuous pressurized air infusion was used for graft centration, graft edge unfolding, and graft unwrinkling.Ten eyes of 10 patients underwent PDEK with donors aged below 40 years. In all eyes, the donor scrolled into tight scrolls. In all cases, the air pump-assisted technique was effective in positioning and centering the graft accurately and in straightening infolded graft edges and smoothing out graft creases and wrinkles. Endothelial cell loss was 38.6%. Postoperative best-corrected visual acuity at 6 months was 0.66 ± 0.25 in decimal equivalent. Continuous pressurized air infusion acted as a third hand providing a continuous pressure head that supported the graft and prevented graft dislocation as well as anterior chamber collapse during intraocular maneuvering. Adequate maneuvering space was available in all cases, and bleeding, if any, was tamponaded successfully in all cases.Although very young donor grafts may be used for PDEK, they are difficult to center and unroll completely before floating against host stroma. An air pump-assisted technique using continuous pressurized air infusion allows successful final graft positioning even with very young donor corneas. It thus makes surgery easier as several key steps are made easier to handle. It additionally helps in tamponading hemorrhage during peripheral iridectomy, increasing surgical space, preventing fluctuations in the anterior chamber depth, and promoting graft adherence. |
| Databáze: | OpenAIRE |
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