Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Association of keratoconus severity with Descemet's membrane perforation and conversion to penetrating keratoplasty in eyes with and without successful big bubble formation

Poster Details

First Author: T. Bozkurt UNITED STATES

Co Author(s):    B. Torun Acar   M. Akdemir   A. Bahadir Kilavuzoglu   S. Acar           

Abstract Details


To report the association of major complications of DALK with Big Bubble (BB) technique (descemet membrane perforation (DMP) and conversion to penetrating keratoplasty (CPK)) with severity of keratoconus and BB formation in our series.


Haydarpasa Numune Training and Research Hospital, Eye Clinic, Turkey


We retrospectively reviewed charts of 144 patients (187 eyes) who underwent DALK with BB technique for treatment of keratoconus between March 2008 and December 2015. Surgeries were continued as layer-by-layer manual keratotectomy when BB could not be achieved after multiple attempts. Eyes were majorly categorized into two groups according to the grade of keratoconus (moderate keratoconus (MK) group (n=40) and advanced keratoconus (AK) group (n=147) and collected data (BB formation, DMP and CPK) was analyzed using Chi Square and Fischer`s exact test. A p value of less than 0.05 was considered statistically significant.


BB was successfully achieved in 131 eyes (70%) (MK group (n=25(62.5%), AK group (n=106(72.1%)). DMP developed in 3(7.5%) and 26(17.6%) eyes in MK and AK groups, respectively. Of these, 1(2.5%) eye in MK group and 16(10.8%) eye in AK group required CPK. There was no significant difference between two groups in terms of BB formation, DMP and CPK.(p˃0.05,for all) In MK group, DMP occurred significantly more common in eyes with failed BB than successful BB (n=3(20%) vs n=0(0%), p=0.04). In AK group, eyes with failed BB required CPK significantly more common than eyes with successful BB when DMP occurred. (n=9(47.3%) vs n=7(100%), p=0.02)


There was no association between severity of keratoconus and major complications of DALK in this series. However, when success of BB formation was evaluated together with severity of keratoconus, development of DMP was found to be very unlikely if BB could be generated successfully in an eye with MK and CPK was always required if DMP occurred in an eye with AK after unsuccessful BB. We think that these findings might be related to the association of severity of keratoconus and structural characteristics of posterior stroma and DM.

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