University of Iowa Health Care

Ophthalmology and Visual Sciences

VA Wet Lab Session 4: Penetrating Keratoplasty

Leo J. Maguire, MD, Mayo Clinic, Rochester, MN
Videography by Randy Verdick, FOPS, The University of Iowa


  • To perform a penetrating keratoplasty on a human cadaver eye
    • To place 24 radial, interrupted sutures


Video Tutorials by section, Leo J. Maguire, MD

Introduction, Leo J. Maguire, MD (2:07 minutes total)

Hand Positioning, Leo J. Maguire, MD (18:18 total)

  • Contents
    • Stability Positions: The Stack Vertically
    • Stability Positions: The Stack Horizontally
    • Colibri Skills
    • Three Point Fixation
    • Grabbing the Needle

Basic Tying and Tying Mistakes, Leo J. Maguire, MD (50:37 total)

  • Contents
    • Basic Tying
    • Making the "T" More Efficient
    • Tying Mistakes: With Straight Tying Forceps
    • Tying Mistakes: With Angle Tying Forceps
    • Judging 45 degrees with the Calibri on the host cornea
    • Needle Parallelism and Marching the needle down the host cornea
    • When your technique is not correct with driving the needle into the host
    • Forceps position on the graft and driving the needle into the graft
    • Things that go wrong with driving the needle into the graft
    • Dr. Maguire showing how to put it all together

Overview of Suturing Steps

Steps of a penetrating keratoplasty

Suturing mistakes

Common mistakes when looping the sutures

Common mistakes when tying

Other trouble shooting tips

Miscellaneous Videos

last updated: 12/10/2014