Manual Medium Incision Cataract Surgery with Descemet’s Stripping Endothelial Keratoplasty: A Novel Triple Procedure

Figure 1

Surgical procedure of combined Descemet’s stripping endothelial keratoplasty and medium incision cataract surgery. (a) Conjunctival limbal peritomy from 7- to 11-o’clock positions (for the right eye). (b) An 8 mm long, straight, partial thickness scleral incision was made with a 2.5 mm crescent knife. Using the crescent knife, a 4 mm long sclerocorneal tunnel was dissected from the scleral incision. (c) Anterior capsulorhexis was performed using a pair of capsulorhexis forceps or a bent 27-gauge needle. (d) Nucleus was delivered with a vectus. (e) Descemet’s membrane was stripped with a reverse Sinskey hook utilizing the epithelial mark as a guide. (f) A 5 mm Sheet glide was inserted into the anterior chamber through the scleral wound. (g) The donor lenticule was transferred endothelial side down onto the viscoelastic-coated Sheet glide. (h) A pair of forceps was utilized to draw the donor lenticule into the anterior chamber through the nasal paracentesis. (i) At the end of the surgery, the anterior chamber was filled with air for 8–10 minutes.

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