Modified surgical technique for improving donor adherence in DSAEK in the aphakic vitrectomized eye

We describe a modified technique for performing Descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with aphakia and vitrectomized eye. A 72-year-old woman presented with corneal decompensation after a complicated cataract surgery and a subsequent vitreoretinal procedure. Before commencing DSAEK, a pars plana infusion cannula was inserted 3 mm from the limbus. The infusion fluid in the vitrectomized posterior segment helped circumvent potential complications, such as recurrent globe collapse, posterior dislocation of the donor disc, and loss of air tamponade. Increasing the infusion pressure allowed the surgeon to levitate the air bubble, effectively vaulting the donor disc against the recipient host bed. This modified approach helps overcome the possible complications of DSAEK in aphakic vitrectomized eyes and enhances donor adherence.