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Air bubble injection in anterior lamellar keratoplasty cases with Descemet's membrane perforation, pros and cons

Poster Details

First Author: S.Eissa SAUDI ARABIA

Co Author(s):                  

Abstract Details



Purpose:

To assess advantages and disadvantages of intracameral air bubble injection, in deep anterior lamellar keratoplasty (DALK) cases with iatrogenic descemet membrane breaks , or near descemet anterior lamellar keratoplasty (ALK) with history of acute hydrops; to guard against descemet membrane detachment .

Setting:

Magrabi Aseer hospital,KSA .

Methods:

Retrospective analysis of DALK and near descemet ALK cases for keratoconus,that required intracameral air tamponade, in the period from 4/2012 till 1/2014.

Results:

70 eyes for anterior lamellar keratoplasty, 21 cases required intracameral air tamponade without peripheral iridectomy performed. Problems with bubble injection included; 2 eyes with papillary block, ending up with Uretts - Zavalia syndrome,2 eyes with trapped segmented bubble pushing inferior iris to the back of cornea and acute elevation of IOP. 14 eyes showed attached descemet membrane with sealed break,and no associated complications.Air bubble augmentation after near descemet ALK and descemet membrane detachment in 3 cases with history of acute hydrops,totally reattached descemet membrane was achieved 2 days postinjection .

Conclusions:

Air bubble injection is a useful tool with ALK cases ,and complications can be avoided by doing peripheral iridectomy with big sized bubble, or by injecting moderate bubble confined to the pupil size. FINANCIAL INTEREST: NONE

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