Descemet Stripping with Automated Endothelial Keratoplasty for Bullous Keratopathies Secondary to Argon Laser Iridotomy-Preliminary Results and Usefulness of Double-Glide Donor Insertion Technique

Abstract

DSAEK is effective in eyes with ALI-induced BK. Our results suggest that insertion with a Busin glide is reliable and associated with less endothelial cell damage than the conventional taco-folding technique. Simultaneous use of IOL glide (Kobayashi double-glide method) to help prevent iris prolapse is our preferred insertion method for narrow-angle eyes.

Severe donor-related Candida keratitis after Descemet’s stripping automated endothelial keratoplasty

“…A diagnosis of bullous keratopathy and cataract was made, and uneventful DSAEK combined with cataract surgery was performed. The lenticle was inserted through a temporal scleral incision using the double-glide technique [7]. When the surgery was completed, the donor corneoscleral rim and storage medium were sent for bacterial and fungal cultures.…”

Double-Glide Method Using Cathereep Protective Sheet As a Substitute in Descemet's Stripping Automated Endothelial Keratoplasty

“…During the DSAEK operation, it is important to minimize the damage to corneal epithelial cells [5][6][7]10]. For this purpose, various operative procedures and devices such as an injector are being developed.…”

“…, and for the double-glide method, an IOL glide which has been reported by Kobayashi et al [6] was used in 5 cases, while Cathereep protection sheet was used for the remaining 5 cases. The operative procedure is summarized as follows:…”

“…One method for the insertion of donor graft is a double-glide method using a Busin glide [5] and an intraocular lens (IOL) glide concomitantly for drawing the donor graft. The usefulness of this method has been reported by Kobayashi et al, and the procedure is increasingly popular [6]. The IOL glide (Alcon Laboratories, Fort Worth, TX, USA) is used to prevent damage to corneal endothelial cells due to direct contact of the donor cells with the iris.…”

Clinical evaluation of non-Descemet stripping automated endothelial keratoplasty (nDSAEK)

“…AE-7802; Asico, Westmont, IL, USA) was used. An ophthalmic viscosurgical device (Viscoat; Alcon Laboratories, Fort Worth, TX, USA) was applied to the endothelial surface of the graft, and the donor graft was inserted using a Busin glide (Moria, Antony, France) alone (1 case), a Busin glide and an IOL sheet glide (double glide technique [16]) (11 cases), an IOL cartridge pull-through method (2 cases), an IOL cartridge push-through method (1 case), the Tan EndoGlide (AngioTech, Reading, PA, USA/Network Medical Products, North Yorkshire, UK) (1 case), or the Neusidl corneal inserter (Fischer Surgical, Arnold, MO, USA) (3 cases). After insertion of the donor graft, the wound was secured with interrupted 10-0 nylon sutures.…”