Dr. ASHOK SHARMA

Abstract

Therapeutic grafts in eyes with extreme thinning and corneal ectasia is a challenge. Therapeutic grafts in these eyes carry a high risk of expulsive haemorrhage, a devastating complication. To combat this, authors present an innovative overlay technique of therapeutic graft. Appropriate sized trephine mark is obtained. The anterior chamber is entered at 6 and 12 o’clock. At 6 o’clock the full thickness incision is extended from 4.30 to 7.30 o’clock. Donor button is sutured in this quadrant. After that 12 o’clock incision is extended from 10.30 o’clock to 1.30 o’clock. Donor button is sutured to the recipient cornea in this quadrant. Similarly, nasal side host cornea is incised full thickness and donor button is sutured. The host cornea is finally incised temporally, iridocorneal adhesions lysed and removed. The donor button is sutured temporally completing the procedure. Our innovative technique of overlay therapeutic corneal grafts prevents expulsive haemorrhage.