Dr. NIDHI GAJENDRAGADKAR

, Dr.Bibhuti P. Kashyap, Dr.DR. BIRENDRA PRASAD KASHYAP, Dr.BHARTI KASHYAP

Abstract

Positive pressure in full thickness keratoplasties can cause multiple complications.If the host corneal button is already cut, sandwich keratoplasty can be done for graft placement. The host corneal button(HCB) is kept in situ after cutting and is SANDWICHED between the donor graft(DG) above and the iris below. Once the DG is sutured with 4 cardinal sutures, the cardinal sutures of the SANDWICHED HCB are released and it is slid out from beneath the DG. The anterior chamber is formed with viscoelastic. This technique gives immediate anterior chamber formation, prevents sudden decompression and leaves no time of open to sky, thus preventing all the complications associated with an open sky surgery. Viscoelastic placement between the DG and HCB minimizes endothelial damage to the DG. In a total of 30 cases with DG >12 mm, positive vitreous pressure was noted in 7 cases, sandwich keratoplasty was performed in 5 cases with desirable post operative results.