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

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 evalu...

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Autores principales: Kobayashi, Akira, Yokogawa, Hideaki, Sugiyama, Kazuhisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398076/
https://www.ncbi.nlm.nih.gov/pubmed/22807910
http://dx.doi.org/10.1159/000339835
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author Kobayashi, Akira
Yokogawa, Hideaki
Sugiyama, Kazuhisa
author_facet Kobayashi, Akira
Yokogawa, Hideaki
Sugiyama, Kazuhisa
author_sort Kobayashi, Akira
collection PubMed
description 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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spelling pubmed-33980762012-07-17 No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty Kobayashi, Akira Yokogawa, Hideaki Sugiyama, Kazuhisa Case Rep Ophthalmol Published online: June, 2012 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. S. Karger AG 2012-06-26 /pmc/articles/PMC3398076/ /pubmed/22807910 http://dx.doi.org/10.1159/000339835 Text en Copyright © 2012 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published online: June, 2012
Kobayashi, Akira
Yokogawa, Hideaki
Sugiyama, Kazuhisa
No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title_full No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title_fullStr No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title_full_unstemmed No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title_short No-Touch Technique and a New Donor Adjuster for Descemet's Stripping Automated Endothelial Keratoplasty
title_sort no-touch technique and a new donor adjuster for descemet's stripping automated endothelial keratoplasty
topic Published online: June, 2012
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398076/
https://www.ncbi.nlm.nih.gov/pubmed/22807910
http://dx.doi.org/10.1159/000339835
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