Graft Detachment in DSEK
Graft detachment refers to lack of adherence of the donor lenticule to the posterior stroma and is the most common complication following DSEK.
Dislocations decrease with increased surgeon experience.
It may refer to the presence of a fluid cleft in the interface or complete detachment of the graft from the posterior stromal bed.
Poor endothelial pump function, viscoelastic in the interface, inadequate air fill, interface fluid, or eye rubbing represent potential causes for graft dislocation.
If the graft is completely detached, the donor lenticule must be repositioned with air injection.
An ideal way to avoid graft dislocation is to make sure the eye is not too soft at the end of the procedure. A partial detachment or fluid cleft may be observed during the immediate postoperative course as a small or inferiorly located cleft may spontaneously reattach.
Image from Rajan Eye Care Hospital
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