Double-Line Reflection Pattern as a Simple Method to Determine Graft Orientation of Descemet Membrane Endothelial Keratoplasty

Purpose:To describe a simple finding, consisting of a double-line reflection from the graft inside the anterior chamber, that can be used to determine the correct donor tissue orientation in Descemet membrane endothelial keratoplasty: which we would like to call Berrospi's sign.Methods:Evaluation of the presence of linear reflection from the donor tissue when implanted in the anterior chamber.Results:A distinctive double-line reflection pattern was identified when careful observation of the curls of the scroll was performed under the surgical microscope, which was a confirmatory sign that the graft was in the correct position.Conclusions:This method of confirming correct graft orientation requires no additional procedures, equipment, or manipulation of the donor tissue and can be used in conjunction with other marking methods already described.