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September 1989

Managing Posterior Pressure During Pseudophakic Keratoplasty

Author Affiliations

From the Departments of Ophthalmology, Texas Tech University, Health Sciences Center, Lubbock (Dr McCartney), and The Johns Hopkins Hospital, Baltimore (Drs Gottsch and Stark).

Arch Ophthalmol. 1989;107(9):1384-1386. doi:10.1001/archopht.1989.01070020454054

• Positive vitreous pressure during penetrating keratoplasty can be difficult to manage. Despite preventive measures, positive vitreous pressure may occur and appropriate intervention is necessary to prevent serious complications. We describe a technique that may be used intraoperatively to restore a formed anterior segment and to prevent vitreous loss when persistent positive vitreous pressure occurs, while attempting to implant a pseudophakos. A 27-gauge needle, passed across the anterior chamber from limbus to limbus, just anterior to the iris, will stabilize the pseudophakos, restore the anterior chamber depth, and allow donor-tissue suturing.