Mind the Gap: Management of a Dislocated DSAEK Graft in a Unicameral Eye With Congenital Aniridia Using a Suture Pull-Through Technique

Purpose: To describe the surgical management of a dislocated Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) graft using a suture pull-through technique. Methods: A case report of a patient with congenital aniridia, previous penetrating keratoplasty, glaucoma, and prior anterior segment reconstruction, who experienced posterior dislocation of a DSAEK graft. Results: A vitrectomy was performed to remove the nonviable dislocated graft, followed by successful placement of an ultrathin DSAEK graft using a suture pull-through technique. Postoperative recovery was unremarkable, and the graft remained well-centered and attached. Conclusions: The suture pull-through technique offers a reliable approach to DSAEK graft placement in unicameral eyes with complex anatomy, reducing the risk of posterior dislocation.