Microbubble incision as a new rescue technique for big-bubble deep anterior lamellar keratoplasty with failed bubble formation
Riss S, Heindl LM, Bachmann BO, Kruse F, Cursiefen C (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 32
Pages Range: 125-9
Journal Issue: 2
DOI: 10.1097/ICO.0b013e31824a226f
Abstract
To describe a new surgical technique allowing dissection down to Descemet membrane in big-bubble deep anterior lamellar keratoplasty (DALK) with failed big-bubble formation (the "microbubble incision technique").This is an interventional case series of 10 consecutive patients with keratoconus undergoing intended big-bubble DALK with failure to establish a normal big bubble. In all patients, repeated air injections into the stroma were performed, leaving a whitish colored stroma. Lamellar dissection as far down as possible was then performed within this white tissue. As soon as the anterior chamber was visible, a large remaining intrastromal air bubble was incised with a sharp 15-degree knife introduced perpendicular to the tissue to open up this predescemetic bubble. If deeper air bubbles were still visible, this approach was repeated. Using a blunt spatula, this new layer was then prepared and viscodissection performed.Using this novel approach, in 9 of the 10 patients, it was possible to dissect down to Descemet membrane. Macroperforation made conversion to penetrating keratoplasty necessary in 1 patient. Microperforations not necessitating conversion occurred in 2 patients. All 9 patients with "rescued" DALK had an uneventful postoperative course and had a mean visual acuity of 20/63 ± 20/125 (range, 20/500-20/50) and a mean endothelial cell count of 1672 ± 163 cells per square millimeter (range, 1493-1867 cells/mm) at 3 months.Microbubble incision is a new rescue technique for big-bubble DALK patients without bubble formation allowing for a safer dissection down to Descemet membrane.
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Germany (DE)How to cite
APA:
Riss, S., Heindl, L.M., Bachmann, B.O., Kruse, F., & Cursiefen, C. (2013). Microbubble incision as a new rescue technique for big-bubble deep anterior lamellar keratoplasty with failed bubble formation. Cornea, 32(2), 125-9. https://doi.org/10.1097/ICO.0b013e31824a226f
MLA:
Riss, Stephan, et al. "Microbubble incision as a new rescue technique for big-bubble deep anterior lamellar keratoplasty with failed bubble formation." Cornea 32.2 (2013): 125-9.
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