Outcomes of air injection within 2 mm inside a deep trephination for deep anterior lamellar keratoplasty

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 10:00

Venue: Hall C1

First Author: : V.Scorcia ITALY

Co Author(s): :    P. Leon   S. Gutfreund   S. Graffi   C. Russo   Y. Nahum        

Abstract Details

Purpose:

To report the success rates of pneumatic dissection employing a minimally invasive technique.based on the injection of air 2 mm inside a deep trephination obtained with a guarded trephine set by means of anterior segment optical coherence tomography (AS-OCT)

Setting:

Opthalmology Department, Villa Igea Private Hospital, Forlì, Italy

Methods:

All eyes included in these study were assigned to 4 groups: Keratoconus(KC) without scar (group 1); KC with scar/hydrops(group 2); non-scarred corneas other than KC (group 3), and scarred corneas other than KC(group 4). In all cases a new technique was used for pneumatic dissection: first a 9mm trephination was performed to reach a depth within 100μm from the endothelial surface (based on the thinnest AS-OCT measurement at this site),then air was injected by means of a cannula advanced 1-2mm centripetally from the bottom of the trephination. Success rate of pneumatic dissection and complications were recorded for each group.

Results:

Two-hundredand ninety eyes of 290 patients were included in the study. Pneumatic dissection succeeded in 81/94 eyes (86.2%); 49/101 (48.5%); 33/43 (76.7%) and 30/52 (57.7%) in group1, 2, 3, and 4 respectively. Complications included: perforation during trephination (n=9); perforation during cannula advancement (n=3); bubble rupture after successful formation (n=30)

Conclusions:

Standardized air injection from a cannula advancedminimally from the base of a deep trephination eliminates the need for subjective judgement of the depth reached during cannula advancement to the center of the cornea. Success rates are high and complications are low even in eyes usually considered unsuitable for pneumatic dissection.

Financial Disclosure:

NONE