ESCRS - POCOR250 - Controlled Air Tamponade–Assisted Descematorrhexis In Dmek Using A 60-Ml Syringe And Irrigation Cannula: Tuwir Techniquel

Controlled Air Tamponade–Assisted Descematorrhexis In Dmek Using A 60-Ml Syringe And Irrigation Cannula: Tuwir Techniquel

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR250 | Type: Free paper | DOI: 10.82333/dm63-yg24

Authors: Mr Mohamed Hosny Abdelrahman* 1 , Dr Mohamed Elghobaier 2 , Dr Ismail Tuwir 3

1Ophthalmology,Imperial College ,London,United Kingdom, 2Ophthalmology,Royal United Hospitals Bath NHS Foundation Trust,Bath,United Kingdom, 3Ophthalmology,King Abdulaziz Medical City,Jeddah,Saudi Arabia

Purpose

To describe and evaluate a simplified, low-cost technique for anterior chamber stabilization and enhanced visualization during descemetorrhexis in Descemet Membrane Endothelial Keratoplasty (DMEK) using controlled air infusion via a 60-mL syringe and irrigation cannula in the absence of an air pump or anterior chamber maintainer.

Setting

Tertiary referral corneal surgery centres including Western Eye Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, and King Abdulaziz Medical City, Jeddah, Saudi Arabia.

Methods

Prospective interventional case series of 13 eyes undergoing DMEK.

During descemetorrhexis:

  • A 60-mL air-filled syringewas connected to a standard irrigation cannula.
  • An assistant applied gentle continuous pressure to maintain anterior chamber stability.
  • The surgeon controlled airflow direction to optimize visualization and prevent air misdirection.
  • Continuous air infusion provided globe stabilization, reducing reliance on external fixation.
  • The irrigation cannula replaced the need for an anterior chamber maintainer.

Outcomes assessed included anterior chamber stability, globe stability during manipulation, ease and precision of descemetorrhexis, surgical efficiency, and intraoperative complications.

 

Results

  • Stable anterior chamber was maintained in all cases.
  • Globe stability improved, facilitating controlled membrane peeling.
  • Controlled airflow enhanced visualization of the Descemet membrane.
  • Directional control minimized turbulence and air misdirection.
  • Descematorrhexis was completed efficiently with minimal manipulation.
  • No air-related intraoperative complications occurred.
  • Surgical workflow was simplified with a reduction in operative time.

Conclusions

Controlled manual air infusion using a 60-mL syringe and irrigation cannula provides a safe, effective, and reproducible method for stabilizing the anterior chamber during descemetorrhexis in DMEK.

The Tuwir Technique uniquely addresses two surgical challenges simultaneously by providing continuous anterior chamber maintenance while stabilizing the globe without the need for external fixation forceps.