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Big bubble deep anterior lamellar keratoplasty from the perspective of the novel predescemetic corneal layer
Author(s) -
GOWEIDA M
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.4774.x
Subject(s) - bubble , perforation , medicine , descemet's membrane , ophthalmology , lamellar structure , corneal perforation , surgery , visual acuity , cornea , materials science , computer science , composite material , parallel computing , punching
Purpose To evaluate the intraoperative findings and complications during big bubble deep anterior lamellar keratoplasty (DALK) based on the newly described predescemetic (Dua layer). Methods A retrospective review of medical records and surgical videos of a series of patients who underwent DALK using the big bubble technique from September 2009 to March 2014. Results One hundred and thirty four eyes were enrolled in this study. Type 1 bubble was achieved in 56 eyes (41.8%) while in 14 eyes (10.4%) type 2 bubble was formed, 2 eyes (1.5%) had mixed bubble. Failure of formation of the big bubble occurred in 62 eyes (46.3%). All eyes with type 1 bubble were completed as DALK with microperforation in 4 eyes. All eyes with type 2 bubble were converted to PKP due to large perforation except 2 eyes were successfully completed as DALK with microperforation in one eye and intact DM in the other. Conclusion Type 2 bubbles are very likely to perforate during removal of the overlying stroma, factors leading to the formation of the thin walled type 2 bubbles should be studied and better strategies to avoid perforation should be adapted.