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Chapter-06 Surgical Technique of Pre-Descemet’s Endothelial Keratoplasty: 15 Steps to Mastering PDEK

BOOK TITLE: Pre-Descemet’s Endothelial Keratoplasty (PDEK)

Author
1. Agarwal Amar
2. Narang Priya
ISBN
9789352703036
DOI
10.5005/jp/books/14154_7
Edition
1/e
Publishing Year
2018
Pages
13
Author Affiliations
1. Dr Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai 600 086, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral road, Chennai-600086, Tamil Nadu (India), Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral road Chennai-600086, Tamil Nadu (India), Dr. Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral road, Chennai-600086, Tamil Nadu (India), Dr Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai, India, Agarwal's Eye Hospital, 13 Cathedral Road, Chennai, India, Eye Research Center and Dr Agarwal’s Group of Eye Hospitals, Chennai, Bengaluru, Trichy, India, and Dubai, United Arab Emirates, Dr. Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai, India, Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai, India, Agarwal’s Eye Hospital, Cathedral Road Chennai, India, Dr Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600 086, India, Dr Agarwal’s Group of Eye, Hospitals and Eye Research Centre, Chennai, Bangalore, Jaipur, Trichy, Salem, Calicut (India), 19 Cathedral Road, Chennai, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, Chennai, Bangalore, Jaipur, Trichy, Salem, Calicut (India), 19 Cathedral Road, Chennai, India, Eye Research Center and Dr Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Trichy, India and Dubai, United Arab Emirates, Dr Agarwal’s Group of Eye Hospitals, 19, Cathedral Road, Chennai, India 15, Eagle Street, Langford Town Bangalore, India, Dr. Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road, Chennai, India, Dr Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Jaipur, Trichy, Salem , 19 Cathedral Road, Chennai, India and Eye Research Centre, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road, Chennai, India, Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, Tamilnadu, India, Dr Agarwal’s Eye Institute, 19, Cathedral Road, Chennai, Tamil Nadu, India, Dr. Agarwal’s group of Eye Hospitals, Chennai, India, Dr Agarwal’s Eye Hospital Pvt Ltd, 19, Cathedral Road, Chennai, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road, Chennai-600 086, Tamil Nadu, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 9, Cathedral Road, C,hennai, India, Dr Agarwal’s Eye Institute, 13 Cathedral Road, Chennai, India, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB 9168, Dubai, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB, Dubai, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, Chennai, India., Dr. Agarwal’s group of eye hospitals at Chennai, Bangalore, Jaipur, Salem and Trichy, India, Dr. Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600086, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre 19, Cathedral Road, Chennai - 600 086, India, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, 19 Cathedral Road, Chennai, India, Eye Research Centre and Dr. Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Trichy, Jaipur, Salem, Kerala, India, Dr. Agarwal’s Group of Eye Hospitals Chennai, India, Agarwal Eye Institute, Chennai, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Center, Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, Chennai, Tamil Nadu, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Center, Chennai, Tamil Nadu, India; Indian Intraocular Implant and Refractive Society (IIRSI), Dr Agarwal's Group of Eye Hospitals, Chennai, Tamil Nadu, India, Dr Agarwal's Group of Eye Hospitals, Chennai, Tamil Nadu, India; Sri Ramachandra Medical College, Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 19-Cathedral Road, Chennai-600086, India, Dr Agarwal's Group of Eye Hospitals and Eye Research Center, Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600086, India, 15 Eagle Street, Langford Town, Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl, Road, Dubai PB 9168, Dubai
2. Narang Eye Clinic, Ahmedabad (India), Narang Eye Clinic, Ahmedabad, India, M and I Institute of Ophthalmology, Ahmedabad, Narang Eye Hospital, Ahmedabad, Gujarat, India, Narang Eye Hospital Ahmedabad, Gujarat, India, Narang Eye Care and Laser Center, Ahmedabad, Gujarat, India
Chapter keywords
Pre-Descemet’s endothelial keratoplasty, PDEK, Descemet’s membrane, DM, donor graft preparation, graft insertion, recipient bed preparation, inferior iridectomy, graft unrolling

Abstract

This chapter presents a brief discussion on surgical technique of pre-Descemet’s endothelial keratoplasty (PDEK). It combines a simplified technique of stripping dysfunctional endothelium and Descemet’s membrane (DM) with the pre-Descemet’s layer (PDL) from the host cornea that is assisted by air dissection and creation of a type-1 bubble. Donor graft preparation comprises as one of the most essential and initial step of the surgery. Recipient bed preparation and graft insertion procedure can be commemorated in short with 15 steps that need to be followed sequentially in the chronological order. All these 15 steps are discussed briefly in this chapter along with the clinical images. The visual outcomes with PDEK procedure have been reported to be very good with good patient satisfaction. It is therefore reasonable for many surgeons to continue performing PDEK, as the overall results are satisfactory.

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