Handheld Slit Beam Techniques to Facilitate DMEK and DALK


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Abstract

Purpose:To describe techniques for using a handheld slit beam to identify the position of detached Descemet membrane in Descemet membrane endothelial keratoplasty (DMEK) and deep anterior lamellar keratoplasty (DALK).Methods:The Eidolon model 510L handheld slit lamp (Eidolon Optical LLC) was used during DMEK cases to identify the orientation of inserted grafts in the anterior chamber before unrolling. In DALK, the beam was used to identify the presence of a big bubble.Results:By using the slit beam technique, a DMEK surgeon can know which side of the partially scrolled graft is endothelium and decide whether to turn it over or inject an air bubble under it. In DALK, the technique allows the surgeon to verify if a big bubble has formed while looking through moderately opacified stroma after air injections.Conclusions:These slit beam techniques should prove useful to lamellar keratoplasty surgeons and improve patient outcomes.

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