Many people are there who suffers from corneal edema and endothelial failure. For the past several years DSAEK or Descemet stripping automated endothelial keratoplasty is considered as an ideal technique instead of the normal surgical procedure. The DSAEK treatment uses stable corneal conture, smaller incisor’s, less induction of astigmatism. The recovery is also quicker compared to normal surgical treatment. Eyes having DSAEK are less prone to subsequent loss of vision.
Procedure
The procedure of the Ultra-thin DSAEK surgery goes through a number of steps. This can be performed easily without wasting any donor tissue. The steps that are included are debulking, refining, mark stromal side, extend dissection, remove tissue and finally punch tissue to proper size.
Debulking
This is the first and foremost step where the tissue is placed at the top of an artificial anterior chamber that is disposable. The pressure of the artificial chamber should be kept constant at it should be of 80-90 mm per Hg. To make sure this measurement remains constant the bottle is placed at a height of 120cm higher from the tissue. The tumbling should be clamped at 50 cm from the starting of the entrance to the chamber. The next step is to measure the thickness of the tissue with the help of ultrasound pachymetry. After this 2 or 3 anterior stroma is removed and finally the residual stroma bed is measured for thickness.
Refining
This is the next step and the tissue is kept mounted upon an anterior chamber and it is rotated 180 degree for performing the second cut. The second is always made at the opposite direction than the first debulking cut. Depending on the thickness of the tissue the cut is made along with a microkeratome head which is of 90- to 200- micrometer of measurement. This second cut must be exactly deeper at the point where the first cut was shallower.
Conclusion
This step is nothing but marking the periphery of the stroma with the help of a 9.0 round marker. This is mainly done in order to visualize extension of the dissection. The other important steps that follow are extending the dissection and removal of the tissue. Punching tissue to the proper size is the most important step.
Procedure
The procedure of the Ultra-thin DSAEK surgery goes through a number of steps. This can be performed easily without wasting any donor tissue. The steps that are included are debulking, refining, mark stromal side, extend dissection, remove tissue and finally punch tissue to proper size.
Debulking
This is the first and foremost step where the tissue is placed at the top of an artificial anterior chamber that is disposable. The pressure of the artificial chamber should be kept constant at it should be of 80-90 mm per Hg. To make sure this measurement remains constant the bottle is placed at a height of 120cm higher from the tissue. The tumbling should be clamped at 50 cm from the starting of the entrance to the chamber. The next step is to measure the thickness of the tissue with the help of ultrasound pachymetry. After this 2 or 3 anterior stroma is removed and finally the residual stroma bed is measured for thickness.
Refining
This is the next step and the tissue is kept mounted upon an anterior chamber and it is rotated 180 degree for performing the second cut. The second is always made at the opposite direction than the first debulking cut. Depending on the thickness of the tissue the cut is made along with a microkeratome head which is of 90- to 200- micrometer of measurement. This second cut must be exactly deeper at the point where the first cut was shallower.
Conclusion
This step is nothing but marking the periphery of the stroma with the help of a 9.0 round marker. This is mainly done in order to visualize extension of the dissection. The other important steps that follow are extending the dissection and removal of the tissue. Punching tissue to the proper size is the most important step.