DMEK Unscrolling Techniques: Pin 'n Roll скачать в хорошем качестве

DMEK Unscrolling Techniques: Pin 'n Roll

Unscrolling DMEK grafts is one of the most challenging parts of learning DMEK surgery. Many "no touch" techniques have been described that can be helpful including bubbles above and below the graft, BSS jets and swift taps with or without digital pressure (sometimes called the Yoeruek technique published in Cornea March 2013). It often requires a combination of these maneuvers and some voodoo to achieve effective unscrolling. In my opinion, a flat anterior chamber is the most critical pre-requisite to effective unfolding. A properly oriented graft is also a huge help (double scroll facing up). By pinning the graft down centrally with a flat chamber, the surgeon is able to roll out the scrolls effectively without changing centration of the graft. The small space between iris and posterior cornea prevents the graft from re-scrolling and allows for the stable injection of air underneath the graft.