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Small bubble deep anterior lamellar keratoplasty in eyes with failed big bubble technique

Poster Details

First Author: M.Goweida EGYPT

Co Author(s):                  

Abstract Details


This study describes a technique to achieve bare Descemet's membrane in eyes with failed big bubble formation.


Main Alexandria University Hospital


Four eyes with failed formation of big bubble during deep anterior lamellar keratoplasty, manual layer by layer dissection technique was performed , multiple tiny intrastromal air bubbles are always present during dissection. Near DM a small bubble was observed in all 4 cases in between DM and the remaining corneal stroma, genle strokes over the remaining stroma by a bunt spatula revealed free movement of this bubble contrary to other minute intrastromal bubbles. Pinching the supradescemet stroma carefully with a fine toothed forceps at the site of this small bubble and injection of viscoelastic at the site of pinching was successful in achieving cleavage of DM from the remaining stroma.


This technique was successful in achieving bare DM in eyes with failed big bubble technique in which predescemet DALK was my target due to failed big bubble formation, micro perforation occured in one eye during removal of the supradescemet stroma, however DALK was completed without any complications in the postoperative period.


Small bubble DALK is effective in baring DM after layer by layer dissection in eyes with failed big bubble formation. FINANCIAL DISCLOSURE?: No

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