Dissection plane in deep anterior lamellar keratoplasty using the big-bubble technique

To find the level of dissection in keratoconic corneas undergoing deep anterior lamellar keratoplasty (DALK) using the big-bubble technique. In 3 keratoconic eyes that underwent DALK, the operation was converted into penetrating keratoplasty after complete big-bubble formation because of extensive t...

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Bibliographic Details
Published inCornea Vol. 29; no. 4; p. 388
Main Authors Jafarinasab, Mohammad Reza, Rahmati-Kamel, Mohsen, Kanavi, Mozhgan Rezaei, Feizi, Sepehr
Format Journal Article
LanguageEnglish
Published United States 01.04.2010
Subjects
Adult
Corneal Stroma - pathology
Corneal Stroma - surgery
Corneal Transplantation - methods
Descemet Membrane - pathology
Descemet Membrane - surgery
Dissection - methods
Humans
Keratoconus - surgery
Keratoplasty, Penetrating
Young Adult
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Summary:To find the level of dissection in keratoconic corneas undergoing deep anterior lamellar keratoplasty (DALK) using the big-bubble technique. In 3 keratoconic eyes that underwent DALK, the operation was converted into penetrating keratoplasty after complete big-bubble formation because of extensive tear in Descemet's membrane (DM) during stromal excision. The corneal stroma and DM taken from these eyes were submitted for light and transmission electron microscopy. Both light and transmission electron microscope revealed a thin layer of corneal stroma adhered to DM in all cases. In 2 eyes, the residual stromal thickness was almost constant (6.4 μm and 12.3 μm), whereas it varied from 9.5 μm to 25.8 μm in the other one. Dissection plane in DALK using the big-bubble technique can be within corneal stroma rather than exactly between stroma and DM. Various corneal pathologies as well as different techniques of dissection may have influence on this level.
ISSN:1536-4798
DOI:10.1097/ICO.0b013e3181ba7016