Increasing Graft Adherence With Topical Glycerin During DSAEK
Purpose
To describe the technique and report the outcomes of a new method of increasing graft adherence during Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK).
Methods
Data on post-operative day one and week one examinations following DSAEK procedure was reviewed. The adverse outcome of interest was lenticule graft detachment. Twenty-seven consecutive patients recently undergoing DSAEK by the same experienced cornea surgeon were included in this study. All surgery cases included in the review were performed with a commonly used DSAEK 5mm insertion technique: graft pull-through via microforceps, traversing the anterior chamber and grasping the donor stroma. Sterile glycerin was transfered into a sterile syringe barrel and used topically during the eight minute air tamponade phase of the procedure. Outcomes of 11 consecutive surgeries using the glycerin application were compared to the other 16 surgeries, which did not have glycerin applied.
Results
Graft adherence was significant higher in the glycerin group (100%), compared to the control group in the non-glycerin group(82%) (p=.04).
Conclusion
This case review suggests that a safe and simple technique of applying topical glycerin onto the cornea during the final phase of DSAEK may help deturgesce the cornea, which can help donor adherence and decrease early detachment.