Early Bubble Modification of the Big Bubble Technique for DALK
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- Category: Vol. 77, December 2009
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Early Bubble Modification of the Big Bubble Technique for DALK,MOHAMAD H. HOSNY, AHMAD M.M. SHALABY and NASHWA M. BADR EL DIN
Abstract
Purpose: To modify the Deep Anterior Lamellar Kerato-plasty Big Bubble technique for more safety and ease of performance.
Methods: We describe our modification of the big-bubble technique that involves injecting the air bubble through the depth of an incision made using a limbal relaxing incision knife in the corneal periphery, 1mm from the limbus. This is done before trephination of the recipient cornea, hence the name "early bubble". The goal of this technique is to reduce the risk of intraoperative corneal perforation and to obtain a large air bubble between Descemet’s membrane and the corneal stroma. We have performed this technique on 21 eyes.
Results: At 6 months 16 eyes showed BCVA of 20/50 and all the rest had BCVA of 20/80 or better. The postoperative corneal astigmatism was 3.6±0.9 diopters at 3 months and after 6 months it was 3.15±0.67 diopters. The rate of conversion to penetrating keratoplasty was 14%.
Conclusion: We find deep anterior lamellar keratoplasty easier, safer and more predictable with this technique.