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Updated: Dec 30, 2025
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Paracentesis as valve re-bubbling technique for Descemet's membrane endothelial keratoplasty (DMEK) graft detachment
Alfonso Vasquez-Perez1, Bruce Allan2, Luis Fernandez-Vega Cueto2
1Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK. alest99@gmail.com.
Introduction:
We present a variation in the slit-lamp microscope re-bubbling technique for DMEK detachment in which a paracentesis is used as a self-sealing valve.
Methods:
Of twenty-eight consecutive DMEK cases, five (18%) required re-bubbling. A 20-gauge side port blade was used to make a paracentesis in the inferior temporal quadrant. A 30-gauge cannula mounted on a 3 ml syringe was employed to inject air using the paracentesis as a valve allowing better control over intraocular pressure and percentage anterior chamber air fill.
Results:
Graft re-attachment was achieved in all cases. One case required two re-bubbling procedures. There were no cases of pupil block glaucoma or other complications.
Conclusion:
Slit-lamp re-bubbling is a practical and safe alternative to taking patients back to the operating room. Using a new paracentesis for valve action control over air injection with a blunt cannula adds better control and may help to reduce complications.
