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Modified big-bubble for deep anterior lamellar keratoplasty
Rajesh Fogla1, T R Indumathy, Luigi Fontana
1From the Eye Department, Apollo Hospitals, Jubilee Hills, Hyderabad, India (Fogla, Indumathy); Ophthalmology Unit, Azienda USL-IRCCS di Reggio, Emilia, Italy (Fontana).
Journal of Cataract and Refractive Surgery
|November 5, 2020
Summary
A modified sequential air injection technique for big-bubble deep anterior lamellar keratoplasty (DALK) safely enlarges bubbles in keratoconus eyes. This method reduces complications compared to the original single injection technique.
Area of Science:
- Ophthalmology
- Corneal Surgery
Background:
- Keratoconus is a progressive thinning of the cornea.
- Deep anterior lamellar keratoplasty (DALK) is a surgical option for keratoconus.
- Achieving a large "big bubble" is crucial for successful DALK.
Purpose of the Study:
- To describe and compare a new sequential air injection technique for big-bubble DALK.
- To evaluate the safety and efficacy of the modified technique in eyes with keratoconus.
Main Methods:
- A comparative analysis of 50 eyes using single air injection (Group 1) versus sequential air injection (Group 2).
- Utilized paracentesis to manage intraocular pressure during sequential air injection.
- Measured bubble size and assessed intraoperative complications.
Main Results:
- Sequential air injection resulted in significantly larger Type 1 bubbles (8.5 mm) compared to single injection (7.8 mm).
- The single injection group experienced complications including bubble bursting (2%) and microperforation (6%).
- The modified technique allowed safe and controlled bubble enlargement with minimal complications.
Conclusions:
- Sequential air injection is a safe and effective modification for big-bubble DALK.
- This technique improves bubble size and reduces intraoperative risks in keratoconus patients.
