By William Brian Neusidl MD FACS
    Cornea/External Disease

    Successful Descemet's Stripping Endothelial keratoplasty (DSEK) is largely dependent upon the atraumatic insertion of the donor button. Many insertion techniques result in the production of folds or striae, damaging the endothelium. We present an innovative technique of rolling the button with a specially designed platform to avoid any endothelial touch, folds or overlap. The donor button is protected from trauma as it passes through the incision. This design facilitates proper orientation and unfolding of the donor button without the use of instrumentation or markings. Irrigation is incorporated within the hand piece, alleviating the need for a chamber maintainer. Video and photographic documentation along with vital dye staining were used to quantify endothelial damage and demonstrate the "no touch", "no fold" technique.