Channels: Cornea | Posted 8/10/2010
Arun Gulani, MD, presents another advance to his "Minimal DSEK," single instrumentation surgery. He has called this procedure Descemeto Rhexis Endothelial Keratoplas T (DREKT) and involves rhexis of Descemet's membrane. Given Dr. Gulani's Corneoplaqstique principles, he aims for emmetropia in all surgeries. He believes that just like Cataract surgery after the invention of Phaco was focused on smaller incisions, astigmatism correction and next day vision outcomes; similarly, corneal surgery should be minimalistic in intervention, elegant to look at and visually promising. In this regards, having performed the surgery using his single instrument technique (modified Sinskey), he now scores the Descemet's membrane by tearing at the periphery in a rhexis movement instead of pulling through the center thus avoiding any posterior stromal scarring which could affect vision outcomes. The Gulani "Gyration" Sign implies good adherence between the graft and recipient Cornea. Even the draining incisions are made to serve a simultaneous function of astigmatism correction along the steep axis. The sutureless incision is covered with theadjacent conjunctival flap and glued in place for an excellent visual and aesthetic outcome.