Figure 1.
The standard DSAEK suture pull-through technique:
(A) Stripping of the Descemet membrane. (B) The donor lenticule is folded into a “taco” shape with endothelial cells enclosed. The “taco” was then placed in the Busin Glide and pulled through with forceps. (C) An anchoring 10/0 prolene stitch was placed on the donor disc at the 6 o’clock position. (D) The Busin glide was brought to the main limbal incision at the 12 o’clock position. (E) The donor lenticule disc was inserted by pulling the stitch and the disc into the anterior chamber under small flow irrigation. (F) Suturing the main incision. The donor lenticule is unfolded by increased irrigation. The anchoring prolene stitch is then cut. (G) The fluid between the lenticule and plant bed is removed and a slit lamp is used to confirm good attachment. (H) A lenticule-size bubble is injected.
Table 1.
Corneal Endothelial Disease.
Figure 2.
A. Bullous Keratopathy before DSAEK with a clear lens. B. Clear corneal endothelial lenticule with a clear lens 12 months after DSAEK.
Figure 3.
A. The ACD after DSAEK was 2.88 mm without the lenticule obstructing the anterior chamber. B. The full thickness of the cornea after DSAEK is 0.85 mm.
Table 2.
Surgical Complications.
Table 3.
Current Studies about DSAEK on Phakic Eyes.