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Massimo Busin, MD; Priya R. Bhatt, MRCOphth; Vincenzo Scorcia, MD

Arch Ophthalmol. 2008;126(8):1133-1137.

In an attempt to enhance postoperative survival of donor endothelium, the conventional technique for Descemet membrane stripping automated endothelial keratoplasty (DSAEK) was modified using the prototype of a glide specially designed to facilitate graft delivery and minimize surgical trauma. Instead of using the so-called taco technique, the Busin glide is loaded with the donor lamella, and a microincision forceps is inserted into a temporal side entry and passed across the anterior chamber, exiting through a nasal clear cornea tunnel to grab the graft and drag it into the eye. In 10 patients who underwent DSAEK, mean (SD) postoperative endothelial cell loss was 20.0% (2.6%) at 6 months, 23.5% (2.8%) at 12 months, and 26.4% (2.7%) at 18 to 24 months. Reduced trauma to the graft using our modified technique limits endothelial cell loss after DSAEK to the level recorded after conventional penetrating keratoplasty (PK).

Author Affiliations: Departments of Ophthalmology, Villa Serena Hospital, Forlì, and University Magna Graecia, Catanzaro, Italy (Drs Busin and Scorcia); and Ophthalmology Department, Royal Bolton Hospital, Bolton, England (Dr Bhatt).

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