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Ultrathin DSAEK : The Present Status
Author(s) -
Busin M.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0073
Subject(s) - medicine , phacoemulsification , corneal transplantation , keratoprosthesis , ophthalmology , corneal disease , vitrectomy , cataract surgery , cornea , surgery , visual acuity
The lecture will present a complete review of Descemet Stripping Automated Endothelial Keratoplasty ( DSEK ), focussing in particular on the development of the technique for the dissection of ultrathin ( UT ) donor tissue. History as well as basic principles necessary to understand the mechanisms of UT DSAEK will be introduced to the attendees. In setting the indication to UT DSAEK , the author will discuss the role of recipient corneal status, type of endothelial disease, concomitant eye disease (i.e. glaucoma), presence of clear lens and other preoperative factors. The different techniques of conventional DSEK , UT DSAEK and Descemet membrane endothelial keratoplasty ( DMEK ) will be compared, pointing out the single steps, which are instrumental in facilitating surgery, while improving the final outcome. In case of multiple intervention, combined versus sequential procedures (e.g. phacoemulsification, IOL surgery, vitrectomy, etc.) will be discussed. The authors will highlight advantages and disadvantages of different surgical approaches. Possible implications for eye banking will also be addressed, with particular emphasis on preparation and storage of tissue for UT DSAEK and DMEK . Slides and videos of case studies will illustrate the most common complications (i.e. graft detachment, dislocation, failure, rejection etc.) as well as the appropriate solutions.