MAY 15, 2018
Cornea/External Disease, Endothelial Keratoplasty
In this 1-Minute Video, Dr. Priya Narang notes that pre-Descemet’s endothelial keratoplasty (PDEK) includes Dua’s layer along with the Descemet's membrane endothelial complex, and is around 30 μm in thickness. The donor graft is prepared using a 30-gauge needle attached to an air-filled 5 mL syringe in a bevel-up position. The needle is introduced from the rim of corneo-scleral junction, with the endothelial side up, into the mid-periphery. Air is injected, forming a type 1 bubble with a dome-shaped elevation (approximately 7-8 mm diameter). The bubble typically spreads from the center to the periphery, with a distinct edge all around. Trypan blue is injected inside the bubble with a 26-gauge needle introduced from the edge of the bubble. A corneo-scleral scissor is used to cut around the edges of the bubble and harvest the graft. Watch Dr. Amar Agarwal demonstrate 15 steps to mastering PDEK and discuss the benefits of this technique in this interview from AAO 2016.
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