By Donald Tan MD FRCS FRCOphth; Jodhbir S Mehta MBBCH BS; Yong Ming Por MBBS
    Cornea/External Disease

    The current method of donor insertion in Descemet-stripping automated endothelial keratoplasty (DSAEK) surgery requires folding and unfolding donor tissue, which damages endothelium. We present an innovative "pull-through" gliding technique, without folding, which is less traumatic to the endothelium and which reduces primary graft failure rates. This method utilizes a purpose designed microforceps that is employed to pull a previously dissected graft into the anterior chamber over a viscoelastic coated intraocular lens glide. Primary graft failures decreased from 20.0% to 1.7%, and endothelial counts have improved.