DSEK No-fold Needle Insertion Technique
Richard Schulze, Jr., MD, demonstrates a DSEK using a needle insertion technique over a sheet glide. Dr. Schulze explains the donor graft preparation and scoring Descemet's membrane techniques. Then, he uses a diamond keratome to enlarge the wound to 5mm to accommodate the sheet glide. He engages the margin of the donor graft with a needle and pushes it into the eye in one swift movement.
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Comments (4)
The dye is gentian violet. Typically it dissipates in 24 hours or less. Having performed DSEK now for six years, I've found that this technique has the virtue of simplicity, with no prolonged manipulation of a "taco" that can also be quite traumatic to the endothelium.
Great video, thanks. What is the dye used to mark the stromal side of the donor? Is it gentian violet like that used to mark the epithelial surface? How long does this persist in the interface once the graft is placed?
recent studies have shown much less endothelial cell loss compared with forceps folding and inserting. great video with great pearls, thanks!
I dont think it is a very good technique not only because you are losing endothelial cells as you glide the donor endo-side down on the glide but you are not using an anterior chamber maintainer, also increasing the chance of continued contact as the graft enters the anterior chamber over the glide.