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Using new technology, the microscope OPMI Lumera® and RESCANTM 700 of Zeiss company, that includes an integrated optical coherence tomography system, with which deep anterior lamellar keratoplasty with intraoperative pachymetry (DALK pachy bubble) is optimized because of the capacity to observe on the screen the corneal depth during various steps of the surgery achieving greater security and reducing the risk of failure in the separation of stromalDescemet interface. Given the difficulty of finding the correct corneal plane, this technology is a major breakthrough in the lamellar transplants. The case and intraoperative clinical photographs in a patient diagnosed with keratoconus occurs. Case Report: Male 28 years old, diagnosed 5 years ago with keratoconus in his left eye checked by Pentacam®. No history of importance or systemic pathology added. Visual acuity OD: 20/50, BCVA OD: 20/20; OI: 20/400, BCVA OI: 20/400. The ophthalmic examination left eye presents: Munson sign, Fleischer ring and Vogt striae, without corneal opacities. The patient underwent surgery with bubble DALK pachy guided intraoperative OCT successfully. Conclusion: This is a breakthrough technology that enhances intraoperative visualization of the corneal layer, thus optimizing the surgical steps needed to achieve air separation of stromal-Descemet interface by big bubble technique and intraoperative pachymetry (DALK pachy bubble).

Deep Anterior Lamellar Keratoplasty (DALK Pachy bubble) OCT guided. Case Report