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Outcomes of air injection within 2 mm inside a deep trephination for DALK performed for different types of indications

Poster Details

First Author: V.Ravera ITALY

Co Author(s):    P. Leon   C. Bovone   G. Shay   Y. Nahum   M. Busin        

Abstract Details


To evaluate the feasibility of air injection within only 2 mm inside a deep trephination for pneumatic dissection in eyes with different types of indications.


Tertiary care, multi-practice centre, “Villa Igea” private hospital, Forlì, Italy.


A standardized, modified pneumatic dissection was performed in 493 eyes with various indications, divided in the following 4 groups: keratoconus without scar (n=163), keratoconus with scar (n=161), others without scar (n=35) and others with scar (n=134). The main steps of pneumatic dissection included: 1) deep trephination of the recipient, 9mm in diameter, intended within 100μm from the endothelium; 2) insertion of a dedicated cannula at the bottom of the trephination and its advancement within 2mm inside the trephination; 4) air injection. Success rates were calculated for each group and compared for statistical significance using a two-tailed Fisher exact test.


Pneumatic dissection succeeded in 346 of 493 (70%). In the absence of corneal scars, the success rate did not differ significantly (p>0,05) between keratoconus and other indications. The success rate in non-scarred corneas (group 1 and 3) was significantly higher (p=0,001) than that recorded in scarred corneas (group 2 and 4).


A minimally invasive technique allows success rates of pneumatic dissection as high as those of conventional techniques for non scarred corneas. The presence of stromal scars reduces significantly the success rate of pneumatic dissection. However, with this technique pneumatic dissection can be achieved also in more than 50% of scarred corneas.

Financial Disclosure:

travel has been funded, fully or partially, by a competing company

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