Titel | Illustration of tissue harvesting for pre-Descemet’s Endothelial Keratoplasty: Pearls and pitfalls learned from a series of ex-vivo pneumodissections |
Abstract Nr. | 1053 |
Doel | The aim of this study was to demonstrate surgical pearls and pitfalls in type 1 big bubble (BB) formation in pre-Descemet’s endothelial keratoplasty (PDEK) and to correlate these findings with optical coherence tomography (OCT) imaging and histology. |
Methodes | 50 cadaveric human corneal tissue specimens consented for research and not suitable for transplantation were obtained in an eyebank. A BB was formed after intrastromal injection of air into the donor corneoscleral button. The production of type 1, type 2 and type 3 BB’s were recorded. Selected specimens were submitted for imaging with OCT or light microscopy. |
Resultaten | We obtained 31 type I BB’s (63.3%), 12 type II BB’s (24.5%) and 6 type III BB’s (12.2%). Key points illustrated by video analysis included the enlargement of a type 1 BB by injecting storage medium or viscoelastic into the air bubble, and the potential of perforation by increasing its size beyond 8.0mm. The salvage maneuver for a small type 1 BB with a peripheral perforation was viscoelastic injection at the perforation site, and subsequent further pneumodissection. The different methods to prevent a type 2 or type 3 BB formation were highlighted. Histology and OCT confirmed the anatomy of the 3 distinct BB types. |
Conclusie | We present the video analysis of tissue harvesting with pneumodissection for PDEK. The principal points illustrated include the use of storage medium and viscoelastic to enlarge a type 1 BB and to seal peripheral perforation sites. We demonstrate techniques to prevent the formation of a type 2 and type 3 BB. |
Naam | TERMOTE |
Initialen | K |
Instituut | University Hospitals Brussels |
Stad | Brussels |
Naam | White |
Initialen | VA |
Instituut | University of British Columbia |
Stad | Vancouver |
Naam | McCarthy |
Initialen | JM |
Instituut | University of British Columbia |
Stad | Vancouver |
Naam | Holland |
Initialen | SP |
Instituut | University of British Columbia |
Stad | Vancouver |