Choroidal hemorrhage, preplaced sutures, and host-over-donor keratoplasty

An old and currently seldom used technique, true preplaced sutures, is described in a case that was high risk for choroidal hemorrhage (CH). A penetrating keratoplasty technique, termed graft-over-host technique, was used allowing the surgeon to expeditiously close the eye in the event of CH. After partial-thickness trephination, true preplaced sutures through the corneal host tissue were passed. After complete trephination, the corneal donor graft was placed under the host and sutured in a controlled fashion. The preplaced sutures had been drawn immediately, giving a broad secure cover, allowing controlled permanent suturing of the graft while selectively removing the preplaced sutures. When CH occurs, the preplaced sutures allow the surgeon to quickly close the eye securely.