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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The blue bubble technique: an ab-interno approach for Descemet's separation in deep anterior lamellar keratoplasty (DALK) using trypan blue stained viscoelastic device

Poster Details

First Author: E. Livny ISRAEL

Co Author(s):    Y. Nahum   I. Bahar                 

Abstract Details


To describe a novel variant of the “Big-Bubble” Deep Anterior Lamellar Keratoplasty (DALK) using Trypan blue stained viscoelastic device for the creation of a separation bubble between Descemet’s membrane and the posterior stroma.


Ophthalmology department, Rabin medical center, Petach-Tikva, Israel


Ten corneoscleral rims were mounted on artificial anterior chamber. Following limbal paracentesis, the anterior chamber (AC) was filled with air. A Melles’ triangulated spatula was inserted through the paracentesis, with its tip penetrating the AC. Thenafter, the spatula was retracted and pushed into the paracenthesis roof creating a small pocket above the Descemet's. Then, a mixture of Trypan blue and cohesive viscoelastics was injected into this pocket , creating a bubble between the Descemet's to the stroma. Next, a partial thickness trephination was made and the stroma was dissected and removed using DALK scissors till the edge of trephination.


In ten out of ten eye bank eyes the technique was successful in creating a visible predescemetic (Type 1) bubble that could be expanded up to the predicted diameter of trephination. Next, a 7.5mm partial thickness trephination and removal of corneal stroma was uneventfully performed.


The technique herein presented holds a promise of being a relatively easy to perform, predictable and well controlled alternative for achieving a predescemet's-stromal (type 1 bubble) separation during DALK surgery. The trypan blue stained viscoelastic device facilitated the proper visualization and control of the separation bubble and assist in identifying the penetrance to the separation bubble prior to removal of the stromal 'cap'.

Financial Disclosure:


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