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Deep anterior lamellar keratoplasty using blunt-tipped scissors (DALK scissors)

Poster Details

First Author: D. Anwar IRAQ

Co Author(s):                  

Abstract Details


A more reliable alternative technique is needed for completing deep anterior lamellar karatoplasty (DALK) after failure to achieve a big-bubble after pneumatic injection. Manual pre-descemete’s DALK using crescent blade is associated with high risk of perforation and interface irregularity problems.


Niga Eye Center, Erbil, Kurdistan, Iraq


This is a case series of 10 patients (10 eyes) underwent deep anterior lamellar keratoplasty (DALK) utilizing a corneal mini-scissors such as Casteroviejo corneal (Storz) to dissect the corneal stroma to reach the plane between the stoma and Dua layer (predescemetic stroma) when the pneumatic injection fails to achieve a big-bubbles. This dissection takes advantage of the emphysema and microbubbles created in the stroma during pneumatic injection. The parameters were best-corrected visual acuity, refraction and rejection rate. Mean duration of follow-up was one year. Mean age was 22. Mean preoperative best-corrected visual acuity was 0.1. Mean postoperative best-corrected visual acuity was 0.5. (p=0.001). Mean preoperative spherical equivalent of refraction was -14.00 diopter. Mean postoperative spherical equivalent of refraction was -2.00 diopters. (p=0.0001). Endothelial rejection rate was zero.


Scissors DALK visual and survival outcome results are comparable to big-bubble DALK visual and survival outcome results published in other papers. This makes scissors DALK a reliable alternative technique when big-bubble fails.



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