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Case Reports
. 2020 Jan;68(1):174-176.
doi: 10.4103/ijo.IJO_883_19.

Surgical management of post-Descemet stripping automated endothelial keratoplasty interface haze associated with interface deposits

George D Kymionis  1 , Nafsika Voulgari  1 , George A Kontadakis  2 , Dimitrios Mikropoulos  3 , Aleksandra Petrovic  1 , Konstantinos Droutsas  4
Affiliations
Case Reports

Surgical management of post-Descemet stripping automated endothelial keratoplasty interface haze associated with interface deposits

George D Kymionis et al. Indian J Ophthalmol. 2020 Jan.

Abstract

We describe an effective technique for the management of graft-host interface haze associated with interface deposits after Descemet-stripping automated endothelial keratoplasty (DSAEK) with bimanual irrigation/aspiration. A Tan marginal dissector was used to separate the graft from the stroma in the nasal two-thirds of the graft-host interface. The aspiration handpiece was inserted in the interface through the nasal side-port corneal incision and a separate irrigation tip was placed in the anterior chamber (AC) through the temporal corneal paracentesis. Meticulous rinsing of the two-thirds of the interface area and the AC was performed. At the end of the procedure, air was injected into the AC to float the donor graft against the host stromal bed and facilitate graft adherence. Postoperative anterior segment optical coherence tomography and slit-lamp examination confirmed elimination of the interface haze-deposits and a well-attached graft. An improvement in visual acuity was noted.

Keywords: DSAEK complications; Descemet-stripping automated endothelial keratoplasty; interface deposits; interface haze; surgical management.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Slit-lamp photograph 1 month after combined DSAEK with phacoemulsification depicting the diffuse interface opacities
Figure 2
Figure 2
Anterior segment optical coherence tomography 1 month after combined DSAEK with phacoemulsification showing the interface space and the hyperreflective interface deposits between the recipient cornea and the donor lenticule
Figure 3
Figure 3
Slit-lamp examination 1 month after bimanual irrigation/aspiration demonstrating near-complete resolution of the interface opacities. The image remained unchanged at the 3-month follow-up examination
Figure 4
Figure 4
Anterior segment optical coherence tomography 1 month after bimanual irrigation/aspiration depicting the resolution of the interface opacities and total graft attachment
See this image and copyright information in PMC

References

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