Cole Eye Institute - Cleveland Clinic

Advanced Corneal Imaging Sheds Light on Refractive
Shift After DSAEK
Surgeons at Cleveland Clinic Cole Eye Institute have been performing
Descemet’s stripping and automated endothelial keratoplasty (DSAEK), a
new corneal transplant procedure, as part of an IRB-approved prospective
study and believe they have confirmed the reason many patients who have
had this surgery experience a slight shift toward farsightedness.
In DSAEK, which is an alternative to penetrating keratoplasty, a
microkeratome is used to create a donor disc composed of posterior
stroma, Descemet’s membrane and endothelium that is transplanted
onto the posterior stroma of the recipient cornea. This technique often
produces donor lenticles that are thicker in the periphery, and investigators
have speculated that this plays an important role in the development
of hyperopia. William J. Dupps Jr., MD, PhD, a refractive surgeon and
corneal specialist and David M. Meisler, MD, have found that non-uniform
thickness profiles and variable central graft thicknesses both contribute to
refractive shift after DSAEK.
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Cole Eye Instiute Anesthesiology
Subtenon’s Cannula Infusion
Subtenon’s lidocaine injection has been proven to reduce postoperative
pain and systemic analgesia requirements in strabismus surgery. Staff
of the Section for the Cole Eye Institute Anesthesia have advanced
their experience with the technique. Marc Feldman, MD, traveled to
Middlesbrough, UK, to see and learn the technique from Chandra Kumar,
MBBS, at the James Cook Hospital.
Medial Canthal Block
The medial canthal block, a new needle technique, is being used and
further developed at Cole Eye Institute. The purpose of this technique
is to provide optimal regional anesthesia for the dacryocystorhinostomy
procedure to correct chronic tearing of the eyes. J. Victor Ryckman, MD, is
developing resident educational and assessment materials for ophthalmic
anesthesia.
Cole Eye Institute