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J Cataract Refract Surg · Feb 2010
Double-bubble technique to facilitate Descemet membrane exposure in deep anterior lamellar keratoplasty.
- Jun Shimazaki.
- Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan. jun@eyebank.or.jp
- J Cataract Refract Surg. 2010 Feb 1; 36 (2): 193-6.
AbstractSafe and efficient exposure of Descemet membrane is the key to success in deep anterior lamellar keratoplasty. Although widely used, the big-bubble technique has the drawback of difficulty in maintaining appropriate needle insertion depth in the corneal stroma, resulting in injected air sometimes escaping to the peripheral cornea without separation of Descemet membrane. We describe a variation of the big-bubble technique in which air is injected into the anterior chamber before it is injected into the stroma. By observing the reflection created on the surface of the air, a needle can be inserted deep into the stroma without puncturing Descemet membrane. This allows safe and efficient separation of Descemet membrane. Moreover, air in the anterior chamber can be used as an indicator of successful Descemet membrane separation as air is shifted to the periphery with creation of the big bubble.Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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