Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty

被引:10
作者
Anwar, Didar S. [1 ]
Kruger, Matthew M. [1 ]
Mootha, V. Vinod [1 ]
机构
[1] Univ Texas SouthWestern Med Ctr, Dept Ophthalmol, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
来源
CLINICAL OPHTHALMOLOGY | 2014年 / 8卷
关键词
scissors; blunt; dissection; big bubble; DALK;
D O I
10.2147/OPTH.S63300
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a "big bubble" detachment of Descemet's membrane (DM) with deep intrastromal pneumatic injection. Methods: The technique utilizes blunt lamellar dissection with blunt-tipped corneal mini scissors as an alternative to a crescent blade, which can be difficult for surgeons to master and is associated with a high risk of perforation. Results: Other techniques of blunt dissection, such as the Melles technique, cannot be utilized after failure to achieve a big bubble, as emphysema in the stroma prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of DM created by the pneumatic injection. Conclusion: This technique provides deep anterior lamellar keratoplasty surgeons with a simple, alternative method of baring DM or achieving a pre-DM plane with minimal residual stroma, after failure to achieve a big bubble.
引用
收藏
页码:1849 / 1854
页数:6
相关论文
共 12 条
[1]   Deep lamellar keratoplasty - Surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet's membrane [J].
Anwar, M ;
Teichmann, KD .
CORNEA, 2002, 21 (04) :374-383
[2]   Outcomes of deep anterior lamellar keratoplasty following successful and failed 'big bubble' [J].
Bhatt, Uday K. ;
Fares, Usama ;
Rahman, Imran ;
Said, Dalia G. ;
Maharajan, Senthil V. ;
Dua, Harminder S. .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2012, 96 (04) :564-569
[3]   Histopathological changes after deep anterior lamellar keratoplasty using the big-bubble technique' [J].
Braun, Joachim M. ;
Hofmann-Rummelt, Carmen ;
Schloetzer-Schrehardt, Ursula ;
Kruse, Friedrich E. ;
Cursiefen, Claus .
ACTA OPHTHALMOLOGICA, 2013, 91 (01) :78-82
[4]   Human Corneal Anatomy Redefined A Novel Pre-Descemet's Layer (Dua's Layer) [J].
Dua, Harminder S. ;
Faraj, Lana A. ;
Said, Dalia G. ;
Gray, Trevor ;
Lowe, James .
OPHTHALMOLOGY, 2013, 120 (09) :1778-1785
[5]   Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus [J].
Fontana, Luigi ;
Parente, Gabriella ;
Tassinari, Giorgio .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2007, 143 (01) :117-124
[6]   Histopathology and Spectral Domain OCT Findings of Pneumatic-Assisted Dissection in DALK [J].
Kim, Soo Yeon ;
Muftuoglu, Orkun ;
Hogan, R. Nick ;
Bowman, R. Wayne ;
Cavanagh, H. Dwight ;
McCulley, James P. ;
Mootha, V. Vinod .
CORNEA, 2012, 31 (11) :1288-1293
[7]   A new surgical technique for deep stromal, anterior lamellar keratoplasty [J].
Melles, GRJ ;
Lander, F ;
Rietveld, FJR ;
Remeijer, L ;
Beekhuis, WH ;
Binder, PS .
BRITISH JOURNAL OF OPHTHALMOLOGY, 1999, 83 (03) :327-333
[8]   Deep anterior lamellar keratoplasty using an original manual technique [J].
Rama, Paolo ;
Knutsson, Karl Anders ;
Razzoli, Giulia ;
Matuska, Stanislav ;
Vigano, Maurizia ;
Paganoni, Giorgio .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2013, 97 (01) :23-27
[9]   Microbubble Incision as a New Rescue Technique for Big-Bubble Deep Anterior Lamellar Keratoplasty With Failed Bubble Formation [J].
Riss, Stephan ;
Heindl, Ludwig M. ;
Bachmann, Bjoern O. ;
Kruse, Friedrich E. ;
Cursiefen, Claus .
CORNEA, 2013, 32 (02) :125-129
[10]   Blunt Cannula for Descemetic Deep Anterior Lamellar Keratoplasty [J].
Sarnicola, Vincenzo ;
Toro, Patricia .
CORNEA, 2011, 30 (08) :895-898