Variant of the big bubble technique in deep anterior lamellar keratoplasty

Fournié, Pierre; Malecaze, François; Coullet, J.; Arné, J L

doi:10.1016/j.jcrs.2006.10.053

Cited by 30 publications

(9 citation statements)

References 11 publications

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“…This surgical technique is well accepted because it is not an intraocular procedure and has several advantages over PKP, such as preservation of endothelium, reduced long-term use of steroids, and rapid visual rehabilitation. 7,15,23,25,27 The safety and efficacy of DALK using the Melles et al technique, 27 the big-bubble technique, 15 or variations of the big-bubble technique 35,36 in moderate to advanced keratoconus cases have been shown in several studies. In the current study, the UDVA and CDVA significantly improved in eyes that had DALK surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of deep anterior lamellar keratoplasty and intrastromal corneal ring segment implantation in advanced keratoconus

Özertürk

Sarı

Kubaloğlu

et al. 2012

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 99%

Comparison of deep anterior lamellar keratoplasty and intrastromal corneal ring segment implantation in advanced keratoconus

Özertürk

Sarı

Kubaloğlu

et al. 2012

Journal of Cataract and Refractive Surgery

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“…He used special forceps and a golf club-shaped diamond knife for hooking the stromal fibers at the trephination wound to expose the DM. Fournié et al 12 introduced a technique that forms an air bubble at the DM-stroma interface by making a corneal stromal nick after lamellar dissection and injecting air via a blunt cannula through the stromal nick. They refilled the airfilled cavity with viscoelastic material, they benefitted from the advantages of an extraocular procedure.…”

Section: Discussionmentioning

confidence: 99%

‘Expanding bubble’ modification of ‘big-bubble’ technique for performing maximum-depth anterior lamellar keratoplasty

Daneshgar

Fallah-Tafti

2011

Eye

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Purpose To describe a new technique for performing maximum-depth anterior lamellar keratoplasty. Methods This was a case series study using a novel method. We introduce and describe a new sign (sunny-side up sign) that reveals the presence and extent of the air bubble at the Descemet membrane (DM)-stroma interface. We also report a novel technique to expand the bubble by injecting viscoelastic material into the bubble cavity and to excise the stromal tissues within the trephination area almost completely. The follow-up period ranged from 12 to 16 months. In all patients we recorded the best spectacle-corrected visual acuity, keratometry, and endothelial cell count preoperatively and postoperatively and the air bubble diameter using the sunny-side up sign. Results In eight of nine patients, a big bubble formed. The size of the air bubble ranged from 2 to 7 mm. All the bubbles were expanded to 8 mm and the bare DM throughout the trephination area was obtained in all cases. The postoperative mean keratometric readings were reduced compared with the preoperative mean keratometric readings. The BSCVA was increased postoperatively compared with the preoperative acuity. The difference between the preoperative and postoperative endothelial cell counts was not statistically significant. Conclusions The early outcomes in our series using the expanding bubble technique suggest that it is safe and easy in performing maximum-depth anterior lamellar keratoplasty.

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“…The literature shows that using a cannula to inject air provides the highest rate of successful BB accomplishment. Fourniè et al indicated a BB success rate of 76.9% in a study of 13 eyes [22] . Sarnicola and Toro reported BB formation in 86% of cases in a study of 28 eyes [21] .…”

Section: Cannula Big Bubblementioning

confidence: 94%

Deep Anterior Lamellar Keratoplasty: Surgical Technique, Indications, Clinical Results and Complications

Sarnicola¹,

Sarnicola²,

Sarnicola³

2015

Cornea

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Deep anterior lamellar keratoplasty (DALK) is currently the procedure of choice to restore transparency and curvature in corneal stromal diseases with a healthy endothelium. Preserving the endothelium avoids endothelial rejection and provides a good and stable endothelial cell count, allowing good long-term graft survival. Several surgical techniques have been proposed over the last years, the most common of which include layer-by-layer manual dissection, hydrodissection, viscodissection, big bubble (needle or cannula) and air-viscobubble. Descemet's membrane rupture represents the most common complication, even in expert hands. The penetrating keratoplasty conversion rate gradually decreases as surgeons become more experienced and learn to manage Descemet's membrane ruptures. Being able to repair the ruptures would increase the success of DALK and allow patients to benefit from all of its advantages. a b cGüell JL (ed): Cornea.

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Variant of the big bubble technique in deep anterior lamellar keratoplasty

Cited by 30 publications

References 11 publications

Comparison of deep anterior lamellar keratoplasty and intrastromal corneal ring segment implantation in advanced keratoconus

Comparison of deep anterior lamellar keratoplasty and intrastromal corneal ring segment implantation in advanced keratoconus

‘Expanding bubble’ modification of ‘big-bubble’ technique for performing maximum-depth anterior lamellar keratoplasty

Deep Anterior Lamellar Keratoplasty: Surgical Technique, Indications, Clinical Results and Complications

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