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Pachymetry-guided intrastromal air injection (“Pachy-Bubble”) for deep anterior lamellar keratoplasty: results of first 100 cases

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Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 16/09/2014 | 08:00-10:30

Paper Time: 08:25

Venue: Boulevard B

First Author: : R.Ghanem BRAZIL

Co Author(s): :    A. Bogoni              

Abstract Details


To report intra-operative and early postoperative results of the Pachy-bubble technique for deep anterior lamellar keratoplasty (DALK).


Sadalla Amin Ghanem Eye Hospital, Joinville, SC, Brazil.


A prospective study including 100 eyes with anterior corneal pathology that underwent Pachy-Bubble technique for DALK, including 78 with keratoconus.


Overall, 95 eyes (95.0%) achieved DALK. It was completed by air-bubble formation in 80 eyes (80.0%), by visco-bubble formation in 7 eyes (7.0%) and by manual layer-by-layer dissection in 8 eyes (8.0%). Intrastromal air injection was tried in 99 eyes, and it formed the bubble in 83 eyes (83.8%). Intrastromal ophthalmic viscosurgical device injection was tried in 9 (9.0%) eyes in the residual stroma, after air injection failed to form the air-bubble, being effective in 7 eyes (7.0%). In keratoconus eyes (n=78), DALK was completed in 73 eyes (92.3%). Air-bubble was achieved in 63 eyes (80.8%), visco-bubble in 4 (5.1%) and manual dissection in 6 (7.7% ). There was a statistically significant improvement in all visual and keratometric parameters. Macroperforations converted to penetrating keratoplasty occurred in 5 eyes (5.0%) and microperforations in 12 (12.0%). Interface haze was observed in 5 eyes (5.0%) and stromal rejection in 9 (9.0%).


The Pachy-bubble technique was reproducible, safe, and highly effective in promoting DALK with air-bubble and visco-bubble formation.

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