Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Endothelial keratoplasty

End presentation for the course Artificial Organs
by

Ahmed Samir

on 5 August 2014

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Endothelial keratoplasty

"If you see it is impossible
you must use others' eyes"

- Toba Beta
Posterior Lamellar Keratoplasty
Endothelial Keratoplasty
APPLICATIONS
INTRODUCTION
CONCLUSION
DLEK
Removal of stroma/endothelium + posterior implant

Small incision DLEK = same – 5 mm incision

DSEK/DAESK
- Stripping DM + posterior implant
-
DSAEK
= same + microkeratome for donor
-
FS-DSEK
= same + femtosecond for donor

DMEK
Stripping DM + implantation of DM without stroma
Advantages of
Endothelial Keratoplasty
Small incision
Less risk of intraoperative complications.

Better eye reistance to trauma.

Less astigmatism.
Less ocular surface complications
Save innervations of patients own cornea.

Less delayed epithelial healing.

Less suture related complications.

Maintaining anterior corneal surface
Fast visual recovery

Minimal changes in corneal power.

More predictable visual outcomes
( no refractive surprises)

Better IOL predictability

Indications
Endothelial kp …..when?
Endothelial decompensation:
VA < 0.4
Morning blurred VA with progressive improvement at the end of the morning.
Photophobia
Patient condition (age, anesthesia….)


Fuchs Dystrophy
Congenital hereditary
endothelial dystrophy

Posterior polymorphous
corneal dystrophy.

Pseudophakic bullous keratopathy

DMEK
High surgical skills required
Donor tissue loss

Failed injection
Failed positioning

Prolonged surgery time
Complication rate higher

Rebubbling needed in 30%
Not suitable for all eyes

No need for special equipment or instrumentation

Very low risk of graft rejection

No tissue add (no hyperopic shift)

No need for a corneal graft (use the endothelium of DALK)

Excellent visual outcomes (mostly attain 20/20 vision)

DSEK
DSAEK VERSUS DMEK
Full transcript