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A detached DSAEK: looking beyond the obvious

Poster Details

First Author: P.Georgoudis GREECE

Co Author(s):    E. Sykakis   S. Hamada   D. Lake        

Abstract Details



Purpose:

We present the investigation and management of a detached DSAEK corneal transplant one week after surgery. It was identified that the DSAEK button was inserted inverted (back-to-front). We describe the technique of surgical inversion and repositioning (including video) and presenting the favourable outcome.

Setting:

Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK

Methods:

A 67 male patient was operated for left cataract and Fuch's endothlelial dystrophy (Combined phacoemulsification & PCIOL implant & DSAEK). He presented a week later with poor vision and the clinical examination demonstrated oedematous cornea and a detached DSAEK graft. Prior to rebubbling an OCT was performed. It revealed that the DSAEK button had been inadvertently inserted back-to-front. The patient was operated the same day, where to DSAEK button was inverted to the correct orientation and rebubbled.

Results:

Three weeks later, the patient has a clear thin DSAEK graft, a BCVA of 6/12 and a cell density of 1450 cells/mm2.

Conclusions:

In case of a detached DSAEK, the use of the OCT is very useful in assessing the orientation. Incorrect orientation does not necessarily lead to graft failure or non reversible damage and with a appropriate surgical management, the result can be very good. FINANCIAL INTEREST: NONE

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