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Big Bubble DALK : The ladder to success, step by step
Author(s) -
Katamish T.
Publication year - 2015
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.1755-3768.2015.0240
Subject(s) - bubble , computer science , economic shortage , materials science , operating system , philosophy , linguistics , government (linguistics)
Summary Deep anterior lamellar keratoplasty ( DALK ) has too many techniques to achieve, one of them and most reproducible is the big bubble technique. The steep learning curve known to this operation some times considered a barrier for many surgeons to try and master. However in my presentation I will try to go through the operation step by step giving my own personal tips and tricks for executing the perfect big bubble DALK . Special emphasis will be put on the following important steps: (1) Trephine adjustment and partial thickness trephination of the recipient cornea. (2) Technique of air injection and big bubble formation, which is considered the key step of this technique. (3) Safe opening of big bubble roof. (4) Cruciate incision and cutting of the reaming stroma after lamellar dissection of superficial corneal layers. (5) Descemet's membrane staining and stripping from donor cornea. Moreover, I will put a focus on the new anatomical pre‐ Descemet's layer (Dua's layer), describing and demonstrating by many video clips the different types (type 1, type 2 and mixed type) of big bubbles based on this new anatomical layer. The aim of my presentation is to allow the participants to perform big bubble DALK in a safe and reproducible way with very high percentage of success in obtaining the big bubble.