Official ESCRS | European Society of Cataract & Refractive Surgeons
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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Deep anterior lamellar keratoplasty, triple procedure: a useful clinical application of the pre-Descemet's layer (Dua's layer)

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Session Details

Session Title: Combined Cataract Surgery: Techniques/Practice Styles

Session Date/Time: Tuesday 13/09/2016 | 14:00-16:00

Paper Time: 14:48

Venue: Auditorium C6

First Author: : A.Zaki EGYPT

Co Author(s): :                        

Abstract Details


To describe a technique which exploits the transparency and toughness of the pre-Descemets layer (Dua's layer) to safely perform deep anterior lamellar keratoplasty (DALK) and phacoemulsification at the same time.


Research Institute of Ophthalmology, Cairo, Egypt


Three DALK procedures combined with phacoemulsification were performed by the same surgeon using the big-bubble (BB) technique at the Research Institute of Ophthalmology, Cairo, Egypt. In two cases a type-1 BB, baring Dua's layer, was achieved and in one case a type-2 BB, baring the Descemet's membrane (DM), was achieved. The surgeries were video recorded and photo slit-lamp images were taken in the follow-up visits.


DALK with phacoemulsification and lens implant was carried out in both patients where a type-1 BB was achieved. At a follow up of 18 months (first case) and 6 months (second case), the best corrected vision was 6/12 for each. In the case where a type-2 BB was achieved, the DM ruptured during injection of viscoelastic prior to capsulorhexis. The procedure was converted to a penetrating keratoplasty without phacoemulsification.


When a type-1 BB is achieved simultaneous DALK and phacoemulsification can be safely accomplished. Dua's layer allows a clear view for performing phacoemulsification with the added benefit of its toughness, which can maintain a stable anterior chamber for cataract surgery. This should not be attempted when a type-2 BB is achieved. Read this article (multiple options)

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