To evaluate the outcomes and feasibility of the use of infant donor tissue (<1 year) in pre-Descemet endothelial keratoplasty (PDEK).Three eyes of 3 patients with pseudophakic bullous keratopathy underwent the procedure in this single-center, prospective interventional series. Diseased Descemet membrane of the recipient cornea was replaced with the pre-Descemet layer-Descemet membrane-endothelium complex stripped from the infant donor cornea (9-12 months old) with the creation of a type 1 bubble. The main outcome measures were best-corrected visual acuity, endothelial cell density, endothelial cell loss, and ease and predictability of the donor lenticule preparation.In the postoperative period, there was improvement in the visual acuity in all the patients. The mean donor endothelial cell density was 3073 ± 68 cells per square millimeter, and the mean postoperative specular count at 6 months was 2230 ± 43 cells per square millimeter. The mean percentage loss of endothelial cells at 6 months was 27 ± 2%. The mean coefficient of variation was 36 ± 5.2%. The mean central corneal thickness measured at a 6-month postoperative period was 515 ± 7 μm. No incidence of tissue loss during graft preparation, graft dislocation, or graft failure was reported. The mean graft thickness as measured with optical coherence tomography on the first postoperative day was 35 ± 3 μm.PDEK using an infant cornea provided an effective means of restoring optical clarity with good visual outcomes. The infant cornea can be a reliable source of donor tissue for the PDEK procedure, and no difficulties were noted in the donor lenticule preparation, insertion of the donor graft, or air bubble management.
Purpose To explain the procedure and technicalities of Glued intraocular lens (IOL) scaffold. Setting Dr Agarwal’s Eye Hospital and Eye Research Centre, Chennai. Methods Following a posterior capsule rupture, the remnant nuclear fragments are manipulated and levitated into the anterior chamber. Glued IOL technique is performed initially followed by IOL scaffold technique. Result Glued IOL scaffold is very effective in compartmentalization of the anterior and posterior chamber and effectively allows nucleus emulsification. Conclusion Glued IOL scaffold prevents the chances of nucleus drop following posterior capsule rupture in eyes with insufficient iris and capsule support.
Purpose To describe a surgical technique for performing pupilloplasty. Methods In this surgical technique for pupilloplasty, after a single pass of needle through the edges of iris defect along the pupillary margin, the suture end is passed through the loop with 4 throws, creating a helical configuration in modified Siepser slipknot technique that is self-retaining and self-locking. Results The technique was performed in 27 cases and the loop did not open in any of the cases in the 6-month follow-up period. No case of iritis was seen. The iris tissue was seen well approximated to each other in all cases. Conclusions The single-pass 4-throw technique serves as an effective method to perform pupilloplasty.
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