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Postoperative position effect on DSAEK graft adhesion

Poster Details

First Author: M.Safir ISRAEL

Co Author(s):    B. Dubinsky-Pertzov   L. Or   A. Rozenberg   E. Pras   A. Einan-Lifshitz   Y. Goldich     

Abstract Details


To assess the effectiveness of maintaining supine position during the first 24 hours after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) surgery in reducing graft detachment rate.


Assaf Harofeh Medical Center, Israel.


In this retrospective, study medical records of patients who underwent uncomplicated DSAEK surgeries between 2010-2018 were reviewed, including nursing documentation of patients' positioning compliance during their postoperative hospitalisation period, which lasts at least 24 hours. For the purpose of the study a patient was considered compliant if he was documented as cooperative with supine position throughout the first 24 postoperative hours.


170 cases were found allegeable. Main indications for surgery were pseudophakic bullous keratopathy (PBK) (48.9%), previous graft failure (28.8%) and Fuch’s endothelial dystrophy (19.4%). Postoperative graft detachment was found in 18.2% of eyes, after an average of 3.48±4.04 days. Twenty-six eyes (15.29%) required rebubbling, and 2 eyes (1.18%) were reoperated on due to postoperative graft detachment. The rates for non-compliance during the first 24 hours in the detached and non-detached groups were 25.81% (n=8) and 14.39% (n=20) respectively. After adjustment for possible confounding factors OR was 1.44 (95% CI: 0.53-3.87, P=0.457).


Although supine postoperative position (2–72 hours) has been widely utilised to ensure graft adhesion, there has been no data regarding the true effectiveness of this method so far. In this retrospective study we did not find a statistically significant influence of prolonged postoperative supine positioning on graft detachment and re-bubble rates after DSAEK.

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