DONOR PREPARATION:
The Daya Lamellar Separator Forceps are available in either reverse action (ref: 2-280) or scissors action style (ref: 2-280-1) and used for lamellar dissection. For DSEK donor preparation, a micrometer knife set at 350 to 400 microns (depending on corneal thickness) is used to make a 4mm limbal incision on the donor. The sharp end of the Daya Lamellar Spear (ref: 6-604) is used to dissect a deep pocket to allow entry of the Lamellar Forceps. The tissue is then dissected by the separating or spreading action of the forceps and is usually very easy to accomplish in a preserved corneal donor. The forceps in their closed state can be used in the same fashion as a conventional lamellar dissecting spatula. The lamellar dissecting end of the Daya Lamellar Spear can be used in conjunction with the Separators to accomplish complete dissection. Once the donor is dissected, it is removed from the block taking care not to damage the endothelial surface. The donor is then punched using a conventional Donor Punch.
RECIPIENT PREPARATION:
Once the donor disc has been created, the recipient eye can be prepared. 3 to 4 paracenteses are performed at the limbus. Aqueous is exchanged for Trypan Blue and allowed to remain in the anterior chamber for 30 to 60 seconds. This is then removed and exchanged for Balance Salt Solution. An AC chamber maintainer is inserted through one of the paracenteses incisions and fluid entry controlled using the foot pedal. A donor trephine (9.0mm if possible) is marked using Gentian Violet and used to mark the epithelial surface of the cornea. A 2.75mm limbal incision is made and the Daya Descemet's Scraper (ref: 6-257) is used to score and scrape Descemet's membrane, commencing diagonally opposite the incision and using the trephine mark as a guide. Descemet's membrane is gradually peeled off and removed from the eye. The limbal wound is then enlarged to 5mm.
IMPLANTATION OF POSTERIOR LAMELLAR DONOR DISC:
A minimal amount of Healon® is placed on the endothelial surface and the posterior lamellar tissue is then over-folded and grasped using the Daya Donor Disc Forceps (ref: 2-2-788) which are used to introduce the donor into the prepared recipient (see right). Air is injected under the donor allowing the donor to unfold and become opposed to the posterior stroma of the recipient cornea. The Daya DSEK manipulators (ref: 6-254 & 6-255) are used through the paracentesis incisions to position the graft centrally. The manipulators have a sharp point enabling the surgeon to grasp the anterior or stromal portion of the Donor Disc. Air is left in the anterior chamber and the pupil is dilated to prevent pupil block. The patient is then checked one hour after surgery to ensure the donor disc is in position and that the intraocular pressure is not abnormally high.

Daya Lamellar Spear (6-604) used to dissect a pocket.

Daya Lamellar Separator Forceps (2-280-1) used to complete dissection

Daya Descemet's Scraper (6-257) used to score and scrape Descemet's membrane.

Daya Donor Disc Forceps
(2-2-788) used to introduce the donor.