DSAEK on an eye with previous penetrating graft, failed after a severe trauma скачать в хорошем качестве

DSAEK on an eye with previous penetrating graft, failed after a severe trauma

This eye had a long and complicated history: Penetrating keratoplasty 20 years ago, followed by a severe blunt trauma few years after the PK surgery, with large wound dehiscence, natural lens expulsion and vitreous loss. We sutured the graft in emergency, with anterior vitrectomy and PC-IOL sutured at sclera. But the graft failed few years thereafter, necessitating a new corneal transplant. This second graft lived several years, but failed three years ago. The patient came now for a new transplant (the third) and we decided to perform DSAEK. In the video we highlight the difficulty to perform the descemetorhexis, due to the poor peripheral visibility and to the presence of a graft spur at the junction of the old graft with the host. Moreover, that spur can jeopardize the good attachment of the DSAEK lamella to the stroma, as we can see in the postoperative OCT images.