A simple method for preventing graft detachment during phacoemulsification cataract surgery after Descemet stripping automated endothelial keratoplasty: A case report

RATIONALE: Graft detachment and endothelial cell damages are 2 major concerns for cataract surgeries in cases after Descemet stripping automated endothelial keratoplasty (DSAEK). We invented a simple but innovative method to anchor the DSAEK graft with sutures during the surgery to avoid possible graft detachment. PATIENT CONCERNS: We present a 59-year-old male who had done DSAEK surgery. Due to progressed blurry vision due to cataract, he underwent sequential cataract surgery 1 year after DSAEK surgery. We applied the method to the patient successfully and the result was satisfying. DIAGNOSIS: Cataract post-DSAEK surgery. INTERVENTIONS: At the beginning of surgery, we made 4 radial fixation sutures with Nylon 10-0 though cornea-DSAEK graft at paracentral point and then through limbus. The sutures were located at 45°, 135°, 225°, and 315°. At the end of surgery, 4 fixation sutures were removed. OUTCOMES: The DSAEK graft was kept well attached during and after the surgery. Only low-grade corneal edema was found postoperation. LESSONS: We provide this special method and applied it to our patient successfully. By using our method, surgeons can reassure graft adhesion during and after surgery, especially for those need cataract surgery after DSAEK surgery.