Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan.
J Cataract Refract Surg. 2010 Feb;36(2):193-6. doi: 10.1016/j.jcrs.2009.08.038.
Safe and efficient exposure of Descemet membrane is the key to success in deep anterior lamellar keratoplasty. Although widely used, the big-bubble technique has the drawback of difficulty in maintaining appropriate needle insertion depth in the corneal stroma, resulting in injected air sometimes escaping to the peripheral cornea without separation of Descemet membrane. We describe a variation of the big-bubble technique in which air is injected into the anterior chamber before it is injected into the stroma. By observing the reflection created on the surface of the air, a needle can be inserted deep into the stroma without puncturing Descemet membrane. This allows safe and efficient separation of Descemet membrane. Moreover, air in the anterior chamber can be used as an indicator of successful Descemet membrane separation as air is shifted to the periphery with creation of the big bubble.
安全有效地暴露Descemet 膜是深板层角膜移植成功的关键。虽然该技术应用广泛，但大泡技术的缺点是难以在角膜基质中保持适当的针头插入深度，导致注入的空气有时会在没有分离Descemet 膜的情况下逃到周边角膜。我们描述了一种大泡技术的变体，在将空气注入基质之前先将空气注入前房。通过观察空气表面产生的反射，可以将针头插入基质深处而不刺破 Descemet 膜。这可以安全有效地分离 Descemet 膜。此外，前房中的空气可以用作成功分离 Descemet 膜的指标，因为随着大泡的形成，空气会被转移到周边。
