Novel Technique for Rebubbling DMEK Grafts at the Slit Lamp Using Intravenous Extension Tubing

Sáles, Christopher S.; Straiko, Michael D.; Terry, Mark A.

doi:10.1097/ico.0000000000000755

Cited by 15 publications

(8 citation statements)

References 16 publications

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“…1,5,6 The detached graft is re-attached with injection of air or sulfur hexafluoride (SF6) into the anterior chamber 7 , (termed anterior chamber re-bubbling). Anterior chamber re-bubbling can be performed at the slit-lamp 8 but may require extensive manipulation especially in case of total detachment and for this reason, most surgeons prefer to perform the procedure in theatre. In both cases, re-bubbling is associated with risks, inconvenience and costs.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Early Graft Detachment in Primary Descemet Membrane Endothelial Keratoplasty

Leon

Parekh

Nahum

et al. 2018

American Journal of Ophthalmology

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Section: Introductionmentioning

confidence: 99%

Factors Associated With Early Graft Detachment in Primary Descemet Membrane Endothelial Keratoplasty

Leon

Parekh

Nahum

et al. 2018

American Journal of Ophthalmology

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“…Different methods for performing rebubbling of DMEK grafts at the slit lamp have been previously described. 6 We feel our technique is a relatively simple procedure that can be performed at the slit lamp, and in the era of COVID-19 avoids the necessity to take the patient to the operating theatre, which had been our standard practice.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 As this requires relatively little manipulation, such rebubbling can be performed at the slit lamp instead of the operating theatre. 6 As a result of the COVID-19 crisis, access to an operating theatre in the United Kingdom is not always readily available in all centres. 7 In cases of early DMEK graft detachment, it had been standard practice in our centre to perform 100% air fill with the patient supine in the operating theatre followed by partial air/fluid exchange.…”

Section: Introductionmentioning

confidence: 99%

Rebubbling of detached descemet membrane endothelial grafts at the slit lamp with 50% air fill after PI-less DMEK during COVID-19 era

Franka

Mistry

Moustafa

et al. 2020

European Journal of Ophthalmology

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Purpose: To describe the effective use of only 50% air fill of the anterior chamber for rebubbling partially detached Descemet Membrane Endothelial Keratoplasty (DMEK) grafts at the slit lamp at a time of restricted operating theatre access during the COVID-19 pandemic. Methods: We present two cases of patients who underwent rebubbling of a partially detached DMEK grafts at the slit lamp following DMEK surgery without peripheral iridotomy. The rebubbling was performed with a 27-gauge needle attached to a 1ml syringe and the patients seated at the slit lamp. Air was injected into the anterior chamber until a 50% air fill was achieved. The patients were instructed to lie supine for 30 min in clinic and the remainder of the day at home. Results: We performed two rebubbling procedures at the slit lamp using the standard needle and syringe. Both cases achieved 50% air fills without any complications. At 3 days post-procedure the air bubble had resolved and the graft appeared attached centrally and at day 14 post-procedure the two patients had a clear and attached corneal graft with corrected visual acuity of 6/7.5 and 6/9, respectively. Conclusion: Rebubbling of detached DMEK grafts at the slit lamp with 50% air fill in the anterior chamber is a relatively simple and effective procedure. This provides an alternative approach for managing the complication of partially detached DMEK grafts in the era of COVID-19 with limited operating theatre access and avoids the risk of complications such as pupillary block in ‘PI-less’ DMEK.

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“…This is a procedure that can be performed either at the slit lamp or under the operating microscope 14. A single rebubble procedure is successful in the vast majority of times.…”

Section: Safetymentioning

confidence: 99%

<p>Descemet membrane endothelial keratoplasty (DMEK): an update on safety, efficacy and patient selection</p>

Trindade¹,

Eliazar²

2019

OPTH

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Novel Technique for Rebubbling DMEK Grafts at the Slit Lamp Using Intravenous Extension Tubing

Abstract: Using IV extension tubing to couple a syringe to a cannula for rebubbling DMEK grafts at the slit lamp is ergonomically superior to the conventional alternative of using a standard cannula on a syringe. The technique is also simple and inexpensive to adopt.

Cited by 15 publications

References 16 publications

Factors Associated With Early Graft Detachment in Primary Descemet Membrane Endothelial Keratoplasty

Factors Associated With Early Graft Detachment in Primary Descemet Membrane Endothelial Keratoplasty

Rebubbling of detached descemet membrane endothelial grafts at the slit lamp with 50% air fill after PI-less DMEK during COVID-19 era

<p>Descemet membrane endothelial keratoplasty (DMEK): an update on safety, efficacy and patient selection</p>

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