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    By Ali A AlRajhi MD
    Cornea/External Disease

    Congenital hereditary endothelial dystrophy (CHED) is characterized by extremely thick, edematous cornea (more than 900 µm) that makes visualization during Descemet stripping and insertion of the graft in Descemet-stripping automated endothelial keratoplasty (DSAEK) very difficult. Certain techniques for overcoming the difficulty will be demonstrated. These will include preoperative use of glycerin drops to reduce corneal thickness, epithelial scraping, Descemet stripping under side-light illumination with trypan blue and OVD use, Busin glide for graft insertion, and portable or Zeiss microscope slitlamp to visualize graft attachment. Successful results of DSAEK and difficulties will be demonstrated.