6 Nisan 2008 (Pazar) 8:00 AM-9:30 AM, Room 175 C (McCormick Place West), ASCRS Paper Session 2-D: CORNEA Keratoplasty, DSEK   Final ID: Comparison of Taco Folding and Glide Insertion Techniques in DSAEK Surgery D. Tan; ; J. S. Mehta; ; Y. M. Por; ; H. Cajucom-Uy; ; R. W. Beuerman; ; A. Parthasarathy; ; Purpose: To compare primary graft failure and donor dislocation rates between Taco Folding and Glide Insertions techniques of donor insertion in DSAEK surgery performed in Asian eyes. Methods: Primary graft failure and donor dislocation rates were compared in a clinical series of 43 consecutive cases of DSAEK surgery, as performed by a single surgeon. Donor insertion through a 5mm scleral tunnel wound was performed in the first 20 cases by the conventional taco folding insertion technique, and unfolded with air or BSS, while an alternative glide insertion technique conceived by the authors was utilised in 23 subsequent surgeries. The latter involved pulling the donor into the AC with intraocular forceps on a modified AC-IOL sheet glide coated with viscoelastic without the need for donor folding or unfolding. Results: Primary graft failure was noted to occur in 5 of the 20 taco folding cases (graft failure rate = 25%) as opposed to only one graft failure in the glide insertion group (graft failure rate = 4.3%). Graft failure in this one case (our first attempt at glide insertion) was related to an attempt to insert a 400 um thick donor which resulted in Descemets detachment. Donor dislocation occurred in one case in the taco folding group, while no cases of donor dislocation were encountered in the glide insertion group. No other complications relating to the glide insertion method occurred. Conclusion: Our glide insertion method appears to be less damaging to donor endothelium as compared to the taco folding method, which results in higher primary graft failure rates in small Asian eyes, and does not predispose to donor dislocation. The glide technique is now our method of choice in DSAEK surgery.