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Surgical techniques
Slit-lamp technique of draining interface fluid following Descemet’s stripping endothelial keratoplasty
  1. Sathish Srinivasan,
  2. David S Rootman
  1. Departments of Ophthalmology, Toronto Western Hospital, Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
  1. Dr S Srinivasan, 6th Floor, New East Wing, Toronto Western Hospital, 399, Bathurst Street, Toronto, M5T 2S8, Ontario, Canada; sathish.srinivasan{at}gmail.com

Abstract

Aim: To describe a new slit-lamp technique for draining interface fluid to manage complete donor disc detachments following Descemet’s stripping (automated) endothelial keratoplasty (DSEK/DSAEK).

Methods: Interventional case series. Five DSEK/DSAEK patients presented on the first postoperative day with complete detachment of the donor lenticule. Slit-lamp biomicroscopy showed interface fluid preventing attachment of the donor disc to the host stromal bed. A new slit-lamp technique is described to drain the interface fluid. This technique involved completely filling the anterior chamber with an air bubble using a 30-gauge needle on a 3 ml syringe. Following this, a 0.12 forceps was used to open the inferior mid-peripheral corneal drainage slit to drain the interface fluid.

Results: This technique was successful in draining the interface fluid in all five patients, leading to immediate complete reattachment of the donor disc.

Conclusion: Donor disc detachments following DSEK/DSAEK can be successfully managed by this slit-lamp technique of draining the interface fluid.

http://dx.doi.org/10.1136/bjo.2007.121012

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    Footnotes

    • Competing interests: None declared.

    • Abbreviations:
      BCVA

      best-corrected visual acuity

      DLEK

      deep lamellar endothelial keratoplasty

      DSAEK

      Descemet’s stripping automated endothelial keratoplasty

      DSEK

      Descemet’s stripping endothelial keratoplasty

      OVD

      ophthalmic viscosurgical device

      PLK

      posterior lamellar keratoplasty

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    Copyright information:

    2007 BMJ Publishing Group