Session Title: Cornea
Session Date/Time: Sunday 05/02/2012 | 08:30-11:00
Paper Time: 10:27
Venue: Hall 1
First Author: : L.Jayasinghe SRI LANKA
Co Author(s): : C. Banagala
"Purpose:
To describe the results of double bubble modification of big bubble technique to facilitate decemet membrane exposure in deep anterior lamellar keratoplasty in a setting with minimal facilities
Setting:
National Eye Hospital, colombo, Sri lanka
Methods:
In 36 patients with Keratoconus and 5 patients with anterior stromal scars, Dalk was performed using double bubble modification. A partial thickness trephination performed. Anterior chamber paracentesis is made. Air bubble injected to anterior chamber. By observing the reflection created on the surface of the air, a 27 G needle can be inserted deep into the stroma without puncturing Descemet membrane. Air injected into stroma to create big bubble. Anterior stromal layer is excised. Stromal incision over big bubble “Brave Slash” is made to decompress big bubble. Viscoelastics injected to stroma – decemat interface. The remaining stroma is excised. Donor lamellar corneal button sutured over recipient decemet. RESULTS In 35 eyes, big bubble was achieved. Among these eyes, two eyes had micro-perforations.
In remaining 7 eyes, three eyes had sucesseful decemet exposure with subsequent visco-elastic injection. Three eyes had near decemet manual dissection; one eye had a macro-perforation and was converted to PKP
Conclusions:
Double bubble modification of the big bubble technique is a safe and efficient way to enhance the success of big bubble formation. This is especially useful in a setting where custom made DALK instruments are not available.
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.
Financial Disclosure:
No"
