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Big-Bubble Combined with Wet-Peeling Technique during Deep Anterior Lamellar Keratoplasty |
Zelin Zhao,Wei Chen |
Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China |
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Abstract Objective: To introduce the surgical technique of big-bubble combined with the wet-peeling technique for deep anterior lamellar keratoplasty. Methods: Form January 2016 to June 2017, 59 Herpes simplex keratitis (HSK) patients at Eye Hospital, Wenzhou Medical University underwent deep anterior lamellar keratoplasty. When performing big-bubble deep anterior lamellar keratoplasty for treatment of herpetic corneal scars, we switched to the wet-peeling technique to finish the surgery if we encountered a type-2 big bubble or small bubbles. Results: Deep anterior lamellar keratoplasty was successfully performed on all 59 eyes with no occurrence of a microperforation. The occurrence rate of type-2 big bubbles was 71%.Conclusions: Type-2 big bubbles occurred in a high proportion of HSK patients. Converting to the wet-peeling technique for type-2 big bubbles or small bubbles, maintained the pre-Descemet's membrane and was a safe procedure.
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Received: 09 October 2017
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Corresponding Authors:
Wei Chen, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China(Email: chenweimd@hotmail.com)
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[5] |
Goweida MB. Intraoperative review of different bubble typesformed during pneumodissection (big-bubble) deep anterior
|
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lamellar keratoplasty. Cornea, 2015, 34(6): 621-624. DOI:10.1097/ICO.0000000000000407.
|
[1] |
Anwar M, Teichmann KD. Big-bubble technique to bare Descemet's membrane in anterior lamellar keratoplasty. J Cataract Refract Surg, 2002, 28(3): 398-403.
|
[2] |
Fontana L, Parente G, Tassinari G. Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. Am J Ophthalmol, 2007, 143(1): 117-124. DOI: 10.1016/j.ajo.2006.09.025.
|
[3] |
McKee HD, Irion LC, Carley FM, et al. Residual corneal stroma in big-bubble deep anterior lamellar keratoplasty: a histological study in eye-bank corneas. Br J Ophthalmol, 2011, 95(10):1463-1465. DOI: 10.1136/bjophthalmol-2011-300360.
|
[4] |
Dua HS, Faraj LA, Said DG, et al. Human corneal anatomy redefined: a novel pre-Descemet's laye(Dua'slayer).Ophthalmology, 2013, 120(9): 1778-1785. DOI: 10.1016/j.ophtha.2013.01.018.
|
[6] |
Zhao Z, Li J, Zheng Q, et al. Wet-peeling technique of deep anterior lamellar keratoplasty with hypotonic water and blunt
|
|
dissection for healed hydrops. Cornea, 2017, 36(3): 386-389.DOI: 10.1097/ICO.0000000000001110.
|
[7] |
Ren Y, Wang H, Zheng Q, et al. Long-term outcomes of deep anterior lamellar keratoplasty treating posterior stroma-implicated herpetic corneal opacities. Cornea, 2016, 35(3): 299-304. DOI:10.1097/ICO.0000000000000742.
|
[5] |
Goweida MB. Intraoperative review of different bubble typesformed during pneumodissection (big-bubble) deep anterior
|
|
lamellar keratoplasty. Cornea, 2015, 34(6): 621-624. DOI:10.1097/ICO.0000000000000407.
|
[8] |
Schlötzer-Schrehardt U, Bachmann BO, Tourtas T, et al.Ultrastructure of the posterior corneal stroma. Ophthalmology,
|
20 |
15, 122(4): 693-699. DOI: 10.1016/j.ophtha.2014.09.037.
|
[6] |
Zhao Z, Li J, Zheng Q, et al. Wet-peeling technique of deep anterior lamellar keratoplasty with hypotonic water and blunt
|
|
dissection for healed hydrops. Cornea, 2017, 36(3): 386-389.DOI: 10.1097/ICO.0000000000001110.
|
[7] |
Ren Y, Wang H, Zheng Q, et al. Long-term outcomes of deep anterior lamellar keratoplasty treating posterior stroma-implicated herpetic corneal opacities. Cornea, 2016, 35(3): 299-304. DOI:10.1097/ICO.0000000000000742.
|
[9] |
Lewis PN, White TL, Young RD, et al. Three-dimensional arrangement of elastic fibers in the human corneal stroma. Exp
|
|
Eye Res, 2016, 146: 43-53. DOI: 10.1016/j.exer.2015.12.006.
|
[8] |
Schlötzer-Schrehardt U, Bachmann BO, Tourtas T, et al.Ultrastructure of the posterior corneal stroma. Ophthalmology,
|
20 |
15, 122(4): 693-699. DOI: 10.1016/j.ophtha.2014.09.037.
|
[10] |
Feizi S, Javadi MA, Daryabari SH. Factors influencing bigbubble formation during deep anterior lamellar keratoplasty in
|
|
keratoconus. Br J Ophthalmol, 2016, 100(5): 622-625. DOI:10.1136/bjophthalmol-2015-307111.
|
[9] |
Lewis PN, White TL, Young RD, et al. Three-dimensional arrangement of elastic fibers in the human corneal stroma. Exp
|
|
Eye Res, 2016, 146: 43-53. DOI: 10.1016/j.exer.2015.12.006.
|
[11] |
Leccisotti A. Air-assisted manual deep anterior lamellar keratoplasty for treatment of herpetic corneal scars. Cornea,
|
20 |
09, 28(7): 728-731. DOI: 10.1097/ICO.0b013e3181930a7e.
|
[10] |
Feizi S, Javadi MA, Daryabari SH. Factors influencing bigbubble formation during deep anterior lamellar keratoplasty in
|
|
keratoconus. Br J Ophthalmol, 2016, 100(5): 622-625. DOI:10.1136/bjophthalmol-2015-307111.
|
[11] |
Leccisotti A. Air-assisted manual deep anterior lamellar keratoplasty for treatment of herpetic corneal scars. Cornea,
|
20 |
09, 28(7): 728-731. DOI: 10.1097/ICO.0b013e3181930a7e.
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