Purpose: To present a novel method of reducing rates of graft detachment, the most common postoperative complication of Descemet stripping endothelial keratoplasty (DSEK). Design: Retrospective, interventional case series. Methods: Eighty-three consecutive patients undergoing DSEK for endothelial dystrophy were studied. DSEK was performed in 103 eyes by 2 surgeons (J.D.G. and W.J.S.) at one institution before (n = 83) and after (n = 20) presoaking donor grafts in balanced salt solution (BSS) Plus (Alcon, Fort Worth, Texas, USA). No significant change in the frequency of using other techniques was made during this time. Incidents of tissue detachment after surgery were recorded. Results: Of 83 consecutive DSEK procedures carried out before presoaking the donor tissue in BSS Plus, detachment occurred in 25 (30%). After presoaking, the detachment rate was reduced significantly to 0 (0%) of 20 (P = .0019). Conclusions: Patients undergoing DSEK experienced a significant decrease in rates of graft detachment after adoption of this new technique. The results suggest that presoaking donor tissue in BSS Plus lowers the detachment rate of DSEK grafts.
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