OCT 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/194331

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October 2013 EW CORNEA 59 using a 27-G needle pull-through technique when the tissue has been pulled inside the eye it unfolds stromal side up and endothelium side down so that the chance of having the graft unfold upside down is unlikely. In addition, the ability to insert the tissue with a low anterior chamber infusion allows the eye to remain pressurized throughout the insertion and unfolding maneuvers. The use of a bent 27-G needle in combination with the Busin glide for insertion of the posterior lamellar graft into the anterior chamber in a pull-through technique from a nasal paracentesis is a simple improvement on the traditional Busin glide technique; the needle avoids the use of expensive forceps and allows the surgeon to insert, center, unfold, and fixate the graft to the recipient cornea with air injection using only one maneuver. EW References keratoplasty using a 30-G needle. J Cataract and Refract Surg. 2009 Apr; 35(4): 625-8. 10. Sarnicola V, Toro P. Descemet-stripping automated endothelial keratoplasty by using suture for donor insertion. Cornea 2008; 27: 825-9. 11. Terry MA, Straiko MD, Goshe JM, et al. Endothelial keratoplasty: Prospective randomized, masked clinical trial comparing an injector with forceps for tissue insertion. Am J Ophthalmol 2013; Mar 19. THINK PATIENT SAFETY "LENSAR's cluster of imaging technologies makes it possible to precisely image the exact location and contour of the posterior capsule, which is the 'Holy Grail' for performing safe ReLACS." – Kerry Assil, MD 12. Khor WB, Teo KY, Mehta JS, et al. Descemet stripping automated endothelial keratoplasty in complex eyes: Results with a donor insertion device. Cornea 2013; Feb 26. continued on page 60 At LENSAR™, we're always thinking ahead. That's why we designed the LENSAR Laser System with your patients' safety in mind. The Augmented Reality™ rotating camera captures 10 images from the anterior cornea to the posterior capsule and reconstructs a 3-D model of the eye. Because you'll see exactly where the relevant anatomy is in the eye for all grades of white or brunescent cataracts, you can feel secure in designing an optimum treatment that will maximize outcomes without putting your patients at risk. The LENSAR Laser System. Designed for patient safety, designed for you. Learn more at LENSAR.com 1. Terry MA. The evolution of lamellar grafting technique over 25 years. Cornea 2000; 19: 611-616. 2. Busin M, Bhatt PR, Scorcia V. A modified technique for descemet membrane stripping to minimize endothelial cell loss. Arch Ophthalmol 2008; 126: 133-7. 3. Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea 2006; 25:886-889. 4. Price FW, Price MO. Descemet's stripping with endothelial keratoplasty: Comparative outcomes with microkeratome-dissected and manually dissected donor tissue. Ophthalmology 2006; 113: 1936-1942. 5. Koening SB, Dupps WJ, Covert DJ, et al. Simple technique to unfold the donor corneal lenticule during Descemet's stripping and automated endothelial keratoplasty. J Cataract Refract Surg. 2007 Feb; 33(2):189-90. 6. Terry MA, Shamie N, Chen ES, et al. Endothelial keratoplasty: A simplified technique to minimize graft dislocation, iatrogenic graft failure and pupillary block. Ophthalmology 2008; 115: 1179-1186. 7. Kaiserman I, Bahar I, McAllum P, et al. Suture-assisted vs. forceps-assisted insertion of the donor lenticule during Descemet stripping endothelial keratoplasty. Am J Ophthalmol 2008; 145:986-90. 8. Van Cleynenbreugel H, Hillenar T, Remeijer L. Graft insertion during Descemet-stripping automated endothelial keratoplasty: Pulling the graft inward. J Cataract Refract Surg. 2008; 34: 534-536. 9. Balachandran C, Ham L, Birball RS, et al. Simple technique for graft insertion in Descemet-stripping (automated) endothelial Scan to learn about LENSAR at AAO 2013

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