Article Text
Abstract
Aim To determine if residual corneal stroma remains on the recipient posterior lamella in big-bubble deep anterior lamellar keratoplasty (DALK).
Methods Pneumodissection using the big-bubble technique was carried out on eye-bank corneas mounted on an artificial anterior chamber. Samples that had a successful big-bubble formation were sent for histological evaluation to determine if any residual stroma remained on the Descemet membrane (DM).
Results Big-bubble formation was achieved in 32 donor corneas. Two distinct types of big-bubble were seen: the bubble had either a white margin (30 corneas) or a clear margin (two corneas). The posterior lamellae of all the white margin corneas showed residual stroma on DM with a mean central thickness of 7.0 μm (range 2.6–17.4 μm). The clear margin corneas showed no residual stroma on DM.
Conclusion It should no longer be assumed that big-bubble DALK, where the bubble has a white margin, routinely bares DM. True baring of DM may only occur with the less commonly seen clear margin bubble.
- Deep anterior lamellar keratoplasty
- big-bubble
- cornea
- neoplasia
- angiogenesis
- imaging
- treatment surgery
- optics and refraction
- treatment lasers
- anterior chamber
- degeneration
- inflammation
- medical education
- wound healing
- eye (tissue) banking
- degeneration
- dystrophy
- intraocular pressure
- treatment surgery
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Footnotes
Funding This work was supported by the NIHR Manchester Biomedical Research Centre.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.