Logo image
Back
Chamber shallowing technique for challenging DMEK cases: Tucking cellulose spears under the speculum to augment posterior pressure
Journal article   Open access   Peer reviewed

Chamber shallowing technique for challenging DMEK cases: Tucking cellulose spears under the speculum to augment posterior pressure

Yong Kam, Matthew Kigin, Eric D Rosenberg, Andrea Blitzer and Christopher S Sales
Indian journal of ophthalmology, Vol.72(Suppl 3), pp.S533-S535
05/2024
DOI: 10.4103/IJO.IJO_1385_23
PMCID: PMC467031
PMID: 38317304
url
https://doi.org/10.4103/IJO.IJO_1385_23View
Published (Version of record) Open Access

Abstract

Some anterior chambers do not readily shallow because of insufficient posterior pressure and/or very deep anterior chamber anatomy, which can make unscrolling descemet membrane endothelial keratoplasty (DMEK) tissue more challenging with an unmodified tap technique. We present a hands-free method for augmenting posterior pressure by temporarily tucking cellulose sponges under the blades of the eyelid speculum. The sponges transfer some of the eyelid speculum’s weight onto the bulbar surface posterior to the iris, thereby indenting the sclera and causing the iris diaphragm to bulge further forward. This hands-free technique can transform a potentially challenging DMEK case into a more straightforward one by facilitating both a shallow anterior chamber and a bimanual unscrolling technique. However, it only works in bicameral eyes with a vitreous body (e.g., an eye with penetrating keratoplasty, vitreous syneresis, and axial myopia) and will not work in unicameral eyes after vitrectomy (e.g., an eye with an Anterior Chamber Intraocular Lens (ACIOL)).

Details

Metrics

11 Record Views
Logo image