Canine Descemet Stripping Endothelial Keratoplasty with a Tissue Insertion Device: Technique and Long-Term Outcome

Table 1

Characteristics of Descemet’s stripping endothelial keratoplasty in human and canine eyes. Surgery in canine eyes carries unique risks and considerations relative to surgery in humans.

	Human	Canine
Diameter of cornea	Approximately 10.5 to 11.5 mm	Approximately 15-16 mm
Pachymetry when presenting for endothelial keratoplasty	Often at 600 microns or beyond [9]	In our practice, an average of 1300 microns
Flexibility of cornea	Cornea usually remains vaulted although chamber may shallow when entering or exiting eye	No Bowman’s layer. Cornea is flexible and can collapse with fluid egress from anterior chamber
Ease of removal of Descemet’s membrane	Can often be removed as a sheet	Tightly adherent. Can be removed in strips and shreds
Visualization of graft	In most cases, the graft is visible, although orientation markings and trypan staining assist with visualization	Limited. Trypan blue recommended. Complete air bubble and adjustment of lighting allows for visualization of graft edge
Postoperative positioning	Patients generally capable of adherence to positioning requirements. Sutures can assist if needed [8]	Frequent, rapid movements are expected. We use sutures to fix the graft and 20% SF6 to provide long-term stability of the gas bubble
Inflammation	Topical steroids	Topical, oral, and sub-Tenon’s injections of steroids and anti-inflammatory medication