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Femtosecond laser-assisted big bubble for deep anterior lamellar keratoplasty
Pratik Y Gogri1, Millicent C Bore, Aaron G T Rips
1From the Cornea Institute, and Refractive Surgery and Cataract Service (Gogri, Reddy, Vaddavalli), L V Prasad Eye Institute, Hyderabad, India; Department of Ophthalmology (Bore), College of Health Sciences, University of Nairobi, Kenya; New York Medical College (Rips), Valhalla, New York, Northwest Eye Surgeons (Rostov), Seattle, Washington, USA.
Purpose:
To assess the utility of a femtosecond laser-assisted stromal channel to assist the creation of a big bubble (BB) for deep anterior lamellar keratoplasty (DALK) surgery in cadaveric corneas.
Setting:
L V Prasad Eye Institute, Hyderabad, India.
Design:
Experimental study.
Methods:
An attempt to create a BB was made on 10 donor pairs of human cadaveric corneoscleral tissues. The 20 corneas were split into 2 groups: Group A underwent femtosecond laser pretreatment and Group B had conventional manual deep lamellar technique. Laser pretreatment was performed using the VisuMax femtosecond laser system to create a stromal channel using the intracorneal ring segment treatment module for direct insertion of the 27-gauge air cannula for pneumodissection at a predetermined depth.
Results:
Of the 20 corneas studied, type 1 BB was achieved in 9 of 10 corneas in Group A and in 7 of 10 corneas in Group B. One cornea from Group A had a combined type 1 and 2 BB, whereas no BB was achieved in 1 cornea.
Conclusions:
Creation of an intrastromal channel using a femtosecond laser at a predetermined depth seemed to be a promising option to increase the chances of achieving a BB when compared with the conventional air injection technique of BB DALK.
