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[Deep anterior lamellar keratoplasty by big-bubble technique]
Patrick Frensel de Moraes Tzelikis1, Juliana Dias dos Santos, Rodrigo Castro Garcez
1Departamento de Córnea, Doenças Externas e Catarata, Hospital Oftalmológico de Brasília - HOB - Brasília (DF), Brazil. tzelikis@terra.com.br
Arquivos Brasileiros De Oftalmologia
|February 15, 2012
Summary
Deep anterior lamellar keratoplasty (DALK) using the big-bubble technique significantly improves vision and reduces astigmatism. This challenging procedure is a rewarding option for suitable keratoplasty patients.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Vision Science
Background:
- Deep anterior lamellar keratoplasty (DALK) is an alternative to penetrating keratoplasty for treating corneal diseases.
- The big-bubble technique aims to improve the success rate of DALK by facilitating a complete Descemet's membrane detachment.
Purpose of the Study:
- To evaluate the efficacy and safety of DALK using the big-bubble technique.
- To assess visual outcomes, refractive changes, and complications associated with this surgical approach.
Main Methods:
- A prospective study involving patients undergoing DALK with the big-bubble technique.
- Evaluation of uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), corneal topography, and endothelial cell density.
- Monitoring for intraoperative and postoperative complications.
Main Results:
- Significant improvements in mean UCVA and BCVA were observed at 12 months post-surgery.
- Mean spherical equivalent and topographic astigmatism showed marked reduction.
- Endothelial cell density decreased post-surgery, and a 10.2% rate of intraoperative microperforation was noted.
- Rare complications included stromal rejection and Urrets-Zavalia Syndrome.
Conclusions:
- DALK with the big-bubble technique offers substantial visual and refractive benefits.
- Despite technical challenges, it is a viable and rewarding surgical option for patients with healthy endothelial cells.
- Careful patient selection is crucial for optimal outcomes in DALK procedures.
