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Amar Agarwal FRCS
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Predescemet Endothelial Keratoplasty (PDEK) involves the transplantation of the descemet membrane with endothelium along with the predescemet's (Dua's) layer. PDEK graft is harvested by the pneumatic dissection of donor cornea through Type 1 big bubble. The technique showed early visual rehabilitation without interface changes and required no advanced equipments. PDEK graft can be harvested in donor eye of all age groups.
Posted: 12/02/2013
Amar Agarwal FRCS
Predescemet Endothelial Keratoplasty (PDEK) involves the transplantation of the descemet membrane with endothelium along with the predescemet's (Dua's) layer. PDEK graft is harvested by the pneumatic dissection of donor cornea through Type 1 big bubble. The technique showed early visual rehabilitation without interface changes and required no advanced equipments. PDEK graft can be harvested in donor eye of all age groups.
Posted: 12/02/2013
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sultan kahtani
11 years ago
Dear Dr. amar i want your vital analysis to my 1st PDEK procedure, pre descemet type 1 bubble did not form with repeated injections i even used 10cc syring. i decided to do DMEK i trephined 8.25 mm bottom of emphysematous Donner then descemet could not be peeled (why? ). finally pre descemet graft made with exhaustive blunt dissection ( i appreciated how strong is the predescemet ) then graft injected into ac, unrolled and bubbled in place and manual blunt dissection PDEK was made. donner age was 50+.
Amar Agarwal
11 years ago
Use a 5 cc syringe connected to a 30 g needle to inject the air . If you get even a small bubble put your needle into it and then continue injecting . If you don't still get the bubble disconnect the needle from the syringe with air and replace a syringe with visco elastic . Start injecting the visco elastic and you will get the bubble . In some 10 to 15 percent of cases if still bb does not form convert to dmek graft . One can separate dm from Duas layer if donor is above 50 years of age . Try some more corneas to get it right . Biggest advantage of Pre Descemets Endothelial Keratoplasty is the donor can be any age . Amar agarwal