A simple technique to improve centration during trephination of the donor lenticula in DSAEK

The author describes a technique to improve centration of the trephination of the donor corneal lenticula during Descemet's stripping and automated endothelial keratoplasty. Following resection of the anterior corneal lamella with the microkeratome, a 10-mm trephine stained with gentian-violet dye is used to mark the perimeter of the resection bed. The remaining donor cornea is centered on the Barron-Hessburg punching block endothelial side up using the easily seen annular mark as a guide. Using this technique, the author has successfully avoided eccentrically trephined donor lenticulae in cases. This simple technique allows the surgeon performing Descemet's stripping and automated endothelial keratoplasty to consistently punch the donor lenticula within the margins of the anterior lamellar resection.