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Clinical outcomes after deep anterior lamellar keratoplasty using big-bubble technique

Poster Details

First Author: A.Veselica SLOVENIA

Co Author(s):    V. Pfeifer              

Abstract Details


To report clinical outcomes of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique.


One surgeon using the big-bubble technique. 32 medical and operating records were retrospectively reviewed. Clinical data used in the study were collected at the last clinical visit.


Preoperative and postoperative uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), spherical equivalent, refractive and topographic astigmatism, and endothelial cell density were measured. Total and residual stromal thickness was measured with spectral domain optical coherence tomography (Heidelberg Engineering, Spectralis®).


31 procedures (96%) were completed as DALK. Intraoperative macroperforation of Descemet’s membrane (DM) occurred in two patients (6%). Formation of a double anterior chamber occurred in three patients. Mean best spectacle-corrected visual acuity was 20/32, and mean spherical equivalent -6.23. Average topographic astigmatism was 7.2 D, and mean manifest cylinder power -4.5. Mean recipient corneal bad thickness was 25.6 ?m. Mean postoperative endothelial cell density was 1885 cells/m2 two years after surgery and 1693 cells/m2 at the final visit. Three patients had certain complications after the surgery, and underwent full-thickness keratoplasthy.


DALK is extraocular procedure and offers potential and valuable advantages in the treatment of certain corneal diseases. The host corneal endothelium is not subjected to immune reaction. DALK shows minor lost of endothelial cells density. Exposed Descemet’s membrane or minimalisation of residual stroma seems to be associated with better visual outcome. FINANCIAL DISCLOSURE?: No

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