Use of a handheld slit beam intraoperatively to assist in big bubble formation during deep anterior lamellar keratoplasty

Alexander S. Davis, Peter Bedard, Joshua H Hou

Research output: Contribution to journalReview articlepeer-review

Abstract

Deep anterior lamellar keratoplasty (DALK) is preferred over conventional penetrating keratoplasty (PKP) for the treatment of anterior corneal opacities or ectasias due to decreased risk of endothelial rejection. However, DALK remains surgically challenging, largely due to challenges associated with achieving consistent pneumo-dissection of posterior stroma from the underlying pre-Descemet's or Descemet's membrane (DM). Air must be injected at sufficient depth in the corneal stroma in order to achieve successful pneumo-dissection, but advancing a needle too deep into the cornea can lead to perforation of DM. We describe here a novel technique using a handheld slit lamp (Eidolon model 510L, Eidolon Optical LLC, Natick, MA, USA) to assist in creation of the big-bubble in DALK surgery. Use of a handheld slit beam intraoperatively is a safe, relatively inexpensive, and effective technique for increasing the success of big-bubble formation in DALK procedures.

Original languageEnglish (US)
Article number4558
JournalAnnals of Eye Science
Volume3
Issue number10
DOIs
StatePublished - Oct 1 2018

Bibliographical note

Funding Information:
This study was supported by an unrestricted grant from the Minnesota Lions Vision Foundation.

Publisher Copyright:
© 2018 Annals of Eye Science. All rights reserved.

Keywords

  • Big bubble technique
  • Deep anterior lamellar keratoplasty (DALK)
  • Slit beam

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