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Visibility of the Retina Through an Air-Filled Anterior Chamber During Simultaneous Vitrectomy and Descemet’s Stripping Automated Endothelial Keratoplasty

Authors Yokogawa H, Kobayashi A, Mori N, Nishino T, Sugiyama K

Received 14 May 2020

Accepted for publication 19 June 2020

Published 24 July 2020 Volume 2020:14 Pages 2119—2123

DOI https://doi.org/10.2147/OPTH.S262403

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Hideaki Yokogawa, Akira Kobayashi, Natsuko Mori, Tsubasa Nishino, Kazuhisa Sugiyama

Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

Correspondence: Hideaki Yokogawa
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8641, Japan
Tel +81-76-265-2403
Fax +81-76-222-9660
Email hyoko@med.kanazawa-u.ac.jp

Purpose: To describe the visibility of the retina through an air-filled anterior chamber during simultaneous pars plana vitrectomy (PPV) and Descemet’s stripping automated endothelial keratoplasty (DSAEK), and to discuss the technical challenges of a fluid-air exchange under such conditions.
Methods: Six eyes from 6 patients with coexisting bullous keratopathy and posterior segment problems such as vitreous opacity, retained silicon oil, intraocular lens subluxation, or aphakia underwent simultaneous PPV and DSAEK. In all cases, after completion of 25-gauge PPV with/without flanged intrascleral intraocular lens fixation, DSAEK donor tissue was inserted into the anterior chamber. Air was then injected into the anterior chamber to attach the donor graft to the back surface of the host cornea. At this point, the visibility of the retina was evaluated using endoillumination and a wide-angle viewing system.
Results: In all cases, visibility of the retina through an air-filled anterior chamber, with the DSAEK donor attached, was sufficient to perform a fluid-air exchange.
Conclusion: Our clinical observations of such rare but clinically important conditions indicate that simultaneous PPV and DSAEK is possible with fair visualization of the posterior segment including the retina.

Keywords: Descemet’s stripping automated endothelial keratoplasty, pars plana vitrectomy

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