Learning Objective

·         Apply principles of corneal suturing to full thickness corneal transplantation to both obtain proper wound closure and minimize astigmatism

Materials

·         Pig/goat eyes

·         Supersharp blades

·         Viscoelastic

·         BSS

·         Fine non-locking needle holders

·         10-0 nylon suture

·         Colibri or straight 0.12 or 0.3 forceps

·         Vannas scissors

·         Tying forceps

·         Vacuum trephine

·         Left and right corneal scissors

Preparation

·         Please read the following:

o   Krachmer section on penetrating keratoplasty

·         Please watch the following videos:

o   Trephination and corneal excision in PKP (will need to create free account if don’t already have one):

§  http://eyetube.net/video/penetrating-keratoplasty-technique/

o   Full surgical video on PKP (may want to mute music)

§  http://www.youtube.com/watch?v=h4FL3jtgU7s

o   V sign in PKP

§  http://www.youtube.com/watch?v=zh5zYhB3yfQ

Procedure

1.       Inject some BSS into the anterior chamber of the pig/goat eye to reform the anterior chamber to physiologic turgor (makes for easier paracentesis incision).

2.       Create a paracentesis incision with a 15 degree blade.  

3.       Fill anterior chamber with viscoelastic.  

4.       Trephine the cornea with the vacuum trephine.  

5.       Excise corneal button with left and right corneal scissors.

6.      Resuture corneal button back in PKP fashion with 16 10-0 nylon interrupted sutures