Descemet’s Stripping Endothelial Keratoplasty (DSEK) | Cornea Colours скачать в хорошем качестве

Descemet’s Stripping Endothelial Keratoplasty (DSEK) | Cornea Colours

Welcome to Cornea Colours, aiming to simplify complex corneal surgeries with key insights, from basics to advanced techniques. Learn, grow, and excel with us DSEK replaces diseased corneal endothelium with healthy donor tissue, typically for conditions like pseudophakic bullous keratopathy. It involves transplanting the donor’s endothelium, Descemet membrane, and posterior stroma, avoiding full-thickness transplantation. Case Summary: A female patient with post-cataract surgery corneal edema and well-positioned IOL was diagnosed with pseudophakic bullous keratopathy. DSEK was planned to restore vision. Key Steps in DSEK: 1. Donor Tissue Dissection •⁠ ⁠Perform epithelial debridement for visibility. •⁠ ⁠Create a 5 mm horizontal incision posterior to the limbus with a 300μ guarded knife. •⁠ ⁠Perform lamellar dissection using crescent (initial 1/3rd), straight (uptil dome), and curved dissectors (final dissection), ensuring complete limbal crossing. 2. Recipient Preparation •⁠ ⁠Debride epithelium sparing the limbus. •⁠ ⁠Fix an AC maintainer and create a corneal tunnel with a crescent knife. •⁠ ⁠Perform Descemetorhexis •⁠ ⁠Score and scrape Descemet membrane. •⁠ ⁠Use trypan blue for delineation and remove DM with a single-port aspiration cannula. 3. Graft Insertion • Place the DSEK lenticule on a Busin glide plate; stain with trypan blue if needed. • Insert the graft into the AC using crocodile forceps. • Center the graft with corneal surface massage. • Inject a full air bubble intracamerally under direct visualization. • Ensure no graft entrapment in side ports. • After 2 hours, perform partial air-BSS exchange, keeping the air bubble above the inferior pupillary plane for optimal positioning. These steps ensure precise and effective graft placement for visual restoration. Disclaimer: This video is meant for the education of eye specialist. The treatment should be done by ophthalmologist based on own clinical judgment.