Reverse graft suturing to avoid Descemet’s membrane detachment of glycerol-preserved donor cornea used for therapeutic penetrating keratoplasty during COVID-19 to overcome the tissue shortage – A novel surgical technique
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Date
2022-03
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Publisher
All India Ophthalmological Society
Abstract
To overcome tissue shortage during pandemic, we switched to 100% glycerol preservation of the donor cornea, which is economical and provides longer duration of storage than the short and intermediate storage mediums we normally use like McCAREY Kaufman (MK) or cornisol. During our initial few cases of therapeutic penetrating keratoplasty using glycerol preserved donor cornea, we faced spontaneous Descemet’s detachments resistant to air tamponade. We tried reverse graft suturing and successfully reinforced Descemet’s attachment along with air tamponade, in one of the cases after multiple failed air injections. In the subsequent two cases of infective keratitis needing therapeutic penetrating Keratoplasty, we took eight reverse sutures in between the eight cardinals, to anchor the Descemet’s membrane of the graft. Both the grafts showed attached Descemet’s and maintained good graft clarity. The reverse corneal suturing technique has not been described to the best of our knowledge and hope this helps our corneal fraternity.
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Keywords
Covid?19, Descemet’s membrane detachment, glycerol?preserved donor cornea, reverse suturing, therapeutic penetrating keratoplasty
Citation
Narayanan Niveditha. Reverse graft suturing to avoid Descemet’s membrane detachment of glycerol-preserved donor cornea used for therapeutic penetrating keratoplasty during COVID-19 to overcome the tissue shortage – A novel surgical technique. Indian Journal of Ophthalmology. 2022 Mar; 70(3): 1042-1046