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Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty: preliminary results

Poster Details

First Author: B.Aydın TURKEY

Co Author(s):    M. Ozmen   N. Yalcin   E. Yuksel   K. Bilgihan   F. Akata  

Abstract Details


To report our early clinical results of blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty (DALK) after failure of big-bubble formation.


Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey


Medical records of patients who underwent DALK between September 2013 and October 2014 were reviewed. Big-bubble formation could not be achieved in 12 patients. After failure to achieve big bubble, manually dissection of stroma with blunt tipped fine scissors was performed in a similar way defined by Anwar et al. In stromal dissection, a piece of stroma is grasped and a lamellar plane is created by opening of the scissors. Corneal lamella was dissected from underlying lamella in a spiral fashion and cut from trephine line circumferentially until a clear desmetic surface or predesmetic space was reached.


12 patients (8 female/4 male) were included in the study. In 4 patients, the procedure turned to partial penetrating keratoplasty due to macroperforation. Baring of desme membrane or predesmetic space was accomplished in 8 cases (67%). In successful DALK group, best corrected visual acuity was 1.29 ± 0.3 logMar before the operation. BCVA was improved to 0.6 ± 0.38 logMar after the treatment (p=0.007). Microperforation occurred in 4 eyes of successful DALK group during stromal dissection. In one patient, double anterior chamber occurred early after the operation which was recovered with injection of sulfur hexafluoride gas into the anterior chamber.


Blunt scissors stromal dissection technique is an effective method to complete DALK after failure to create big-bubble. Longer follow-up period is needed to understand efficacy and safety of the procedure more accurately.

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