Abstract

Purpose-is to show how DMEK scroll suddenly exploded out while injecting it in AC with the injector with ac maintainer still in the AC and getting entangled in the preplaced sutures at the section
Methods-DMEK scroll inserted in the AC with the injector with AC maintainer in AC (on with a very low pressure). Followed by retrieving and reusing the same graft
Results-DMEK scroll reinserted -scroll well attached by the end of surgery and day 1. Due to the intraoperative manipulations the DMEK graft failed and was retaken for DSEK
Learning points
1.Anterior chamber pressure should be very low while injecting the scroll
2.A lims forceps can be placed at the side port to decrease the anterior chamber pressure and depth
3.Sutures should be placed at the main entry so that the graft shouldn’t extrude
4.Bevel of the injector should be facing sideways away from the pupillary axis.
5.Once the scroll is inside the anterior chamber graft should be oriented perpendicular to the incision