A modified technique for descemet membrane stripping automated endothelial keratoplasty to minimize endothelial cell loss

Arch Ophthalmol. 2008 Aug;126(8):1133-7. doi: 10.1001/archopht.126.8.1133.


In an attempt to enhance postoperative survival of donor endothelium, the conventional technique for Descemet membrane stripping automated endothelial keratoplasty (DSAEK) was modified using the prototype of a glide specially designed to facilitate graft delivery and minimize surgical trauma. Instead of using the so-called taco technique, the Busin glide is loaded with the donor lamella, and a microincision forceps is inserted into a temporal side entry and passed across the anterior chamber, exiting through a nasal clear cornea tunnel to grab the graft and drag it into the eye. In 10 patients who underwent DSAEK, mean (SD) postoperative endothelial cell loss was 20.0% (2.6%) at 6 months, 23.5% (2.8%) at 12 months, and 26.4% (2.7%) at 18 to 24 months. Reduced trauma to the graft using our modified technique limits endothelial cell loss after DSAEK to the level recorded after conventional penetrating keratoplasty (PK).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cell Survival
  • Corneal Transplantation / methods*
  • Descemet Membrane / surgery*
  • Endothelium, Corneal / transplantation*
  • Female
  • Fuchs' Endothelial Dystrophy / physiopathology
  • Fuchs' Endothelial Dystrophy / surgery
  • Graft Survival / physiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Visual Acuity / physiology
  • Wound Healing