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Amar Agarwal FRCS
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Amar Agarwal, FRCS, describes the Double Infusion Cannula Technique (DICT) which was developed to perform a combined PDEK and glued IOL fixation in a vitrectomized eye.
Posted: 8/18/2017
Amar Agarwal FRCS
Amar Agarwal, FRCS, describes the Double Infusion Cannula Technique (DICT) which was developed to perform a combined PDEK and glued IOL fixation in a vitrectomized eye.
Posted: 8/18/2017
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Dan Zapp
7 years ago
Amar I see, thanks for the information. Still the innermost layer would be endothelial cells if I'm not mistaken? So pinching inverse Sinskey into the graft from below and repositioning the graft would mechanically affect the central endothelium, wouldn't it? Dan
Amar Agarwal
7 years ago
You are right Dan. The flip side is that we are using young donors with very good endothelium . Also with the Trocar ac maintainer infusing air in the eye the manipulation of the graft becomes easy . We tend to manipulate the peripheral edges of the graft to unroll the edges and center the graft . Amar agarwal
Dan Zapp
7 years ago
I see (not for the first time in your DMEK videos) that at 5:56 you reposition the graft already hovering on an air bubble by hooking inverse Sinskeys into central endothelium. I always thought this to be a no-go. Is the cell loss of that procedure tolerable, esp. since it happens in the center of the graft?
Amar Agarwal
7 years ago
Dan These are all Pre Descemets Endothelial Keratoplasty not dmek . There is a Trocar AC maintainer infusing air into the AC. The small edges can be corrected and unrolled with the reverse sinskey hook . If the graft is de centered it can be centered also easily . This is due to the pre Descemets layer which helps give the graft splinting. Another plus point on pdek is we are using young donors only which gives us better healthy corneas Amar agarwal
Andrew Pan
8 years ago
Great job!