Descemets Stripping Endothelial Keratoplasty (dsek) As An Internal Sealant For Corneal Laceration Or Perforation

摘要

Purpose: : To determine whether a standard DSEK graft would seal experimental full- thickness corneal lacerations or perforation. Methods: : An experimental pilot study, using 5 human globes from the San Diego Eye Bank. Five types of corneal lacerations were created: A 3 mm linear laceration; a 3 mm stellate (cross) laceration, a central descematocele with 3 mm stellate (cross) laceration; central descematocele with 3 mm linear laceration; and a central descematocele with 3x3 mm hole. A central descematocele was formed using a 6 mm trephine. A 4 mm and 1 mm side port limbal incision were created. DSEK graft was inserted centrally to patch the corneal laceration. Injection of a single central bubble was made to hold the DSEK graft. Leaks were checked using the Seidel Test. After 30 min, infusion of BSS with the bottle height of 60 cmH20, leaks were checked. After 5 min the bottle height was brought down to 27 cmH20 and maintained at this level (normal range IOP). Results: : An initial bottle height of 60 cmH20 (pressure of 44 mmHg) maintained to 27 cmH20 (20 mmHg) for 30 min can hold the DSEK graft centrally. This graft seals a 3x3mm corneal perforation and a 3 mm linear and stellate full thickness corneal laceration. Conclusions: : DSEK graft can be used as an effective internal sealant for a 3 mm full thickness linear and stellate corneal laceration or perforation.