Endodiathermal Tautening For Endothelial Keratoplasty

To use endodiathermy for correcting floppy or irregular irides seen during endothelial keratoplasty

Dr. Agarwal's Eye Hospital, Chennai, India

The endodiathermy probe connected to a phacoemulsification machine or a vitrectomy machine was applied in continuous linear setting, (starting at around 20-25% power) to the area of the iris that was floppy. Mid-peripheral application in localized spots was used, with power and duration of application adjusted to induce a mild localized shrinkage and tightening of the iris stroma.  Localized bunching of iris tissue if seen at the site of any pupilloplasty or iridoplasty performed simultaneous with EK was also flattened by applying the endodiathermy probe directly over the protuberant iris tissue or on the area of elevated iris to flatten it out 

The floppiness and convex bulging of the iris is replaced by a flat and somewhat taut iris that gives a uniform AC and better air dynamics in endothelial keratoplasty.

Endodiathermal tautening of a floppy or irregular iris can be achieved allowing better conditions to perform endothelial keratoplasty, thus improving surgical ease, enhancing intra- and post-operative outcomes and decreasing rate of complications of surgery.