TITLE:
A Novel Y-Suture Transfixation Technique to Improve Graft Adherence in High-Risk Descemets Stripping Automated Endothelial Keratoplasty
AUTHORS:
John Cason, Habeeb Ahmad, Pho Nguyen, Martin Heur, Jonathan Song, Samuel C. Yiu
KEYWORDS:
Descemets Stripping Automated Endothelial Keratoplasty, Dislocated Graft Prevention, Sutured Lenticule
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.4 No.3,
August
28,
2014
ABSTRACT: Purpose: To report
a novel Y-suture transfixation technique to improve success rate of high-risk
Descemets stripping automated endothelial keratoplasties (DSAEK). Design: Retrospective
non-comparative case series. Participants: Twenty five high-risk patients
undergoing DSAEK at one tertiary care institution. Methods: A retrospective
evaluation of consecutively enrolled high-risk DSAEK cases performed by three
surgeons at one institution during a 3-year period (2007-2010). Main outcome
measures were graft adherence and suture-related complications. Results: Highrisk
factors were defined as followed: prior incisional glaucoma surgery (58%),
presence of vitreous in the anterior chamber (15%), anterior chamber
intraocular lens (8%), graft dislocation (8%), previous DSAEK (8%), and iris
trauma/aphakia (3%). Twenty-five high-risk patients underwent DSAEK with
Y-suture transfixation. Postoperative follow-up ranged from 3 to 27 months. One
patient had dislocation due to hypotony from prior trabeculectomy (4%),
requiring repeat DSAEK. Neither primary graft failure nor suture-related
complication was observed. Conclusion: The Y-suture transfixation technique is
associated with improved success rate of high-risk DSAEK transplant.