“Copy and Fix”: An advancement on mapping freehand and horseshoe tectonic grafts

Rachel Goh

Meeting:  2015 RANZCO


Date:      -

Session Title: Poster

Session Time:      -

To describe a new technique for mapping freehand and horseshoe tectonic corneal grafts.

Retrospective, noncomparative interventional case series.†3 eyes from 2 patients were included.

One eye had a full thickness freehand tectonic corneal graft for a perforated microbial keratitis too large to glue. Two eyes from the same patient had anterior lamellar horseshoe tectonic grafts for Terrien’s marginal degeneration.

The area to be excised from the host was marked with a marking pen. Using the principle of the light table from architecture, the donor corneoscleral rim was placed over the marked area with an ophthalmic viscoelastic device in the interface to provide a coupling medium. The donor was then marked, tracing the exact shape of the tectonic graft with a 0.25mm overlap (“copy”). This was harvested after mounting on an artificial anterior chamber and sutured in place with 10/0 nylon (“fix”) to provide an exact copy of the eccentric or horseshoe shape of the tectonic graft.

Main Outcome Measured:
Ease of performance, Seidel status and accuracy of fit post operatively.

All three eyes were Seidel negative post operatively and remained so during follow-up. All grafts were easy to perform, relatively fast and tectonically stable post operatively.

The “copy and fix” technique is a simple and effective new technique that consistently and accurately maps freehand and horseshoe tectonic corneal grafts.