Ophthalmology Department, Bambino Gesù Children's Hospital, Rome, Italy.
J Cataract Refract Surg. 2010 Oct;36(10):1631-6. doi: 10.1016/j.jcrs.2010.08.013.
We describe a variant of the big-bubble technique in deep anterior lamellar keratoplasty (DALK) assisted by the IntraLase femtosecond laser, which we call IntraBubble. The use of the 60 kHz IntraLase femtosecond laser allows dissection of the pre-Descemet-plane lamella to a predefined corneal depth and creation of a channel in the posterior stroma 50 μm above the endothelium into which a smooth cannula for air injection can be introduced. We lengthened the channel created by the laser using a pointed dissector. Eleven consecutive patients with keratoconus were treated, and all procedures were completed as DALK. The big bubble was achieved in 8 eyes (73%). In 3 cases (27%), intraoperative microperforations occurred and the procedures were completed with hand dissection without complications. This new application of femtosecond laser technology could lead to standardization of the big-bubble technique in DALK.
我们描述了一种在飞秒激光辅助下的深板层角膜移植术（DALK）中的大泡技术变体，我们称之为 IntraBubble。使用 60 kHz 的 IntraLase 飞秒激光可以将前板层角膜至预先设定的角膜深度分离，并在距内皮层上方 50μm 的后基质中创建一个通道，可将一个用于注入空气的平滑套管引入该通道。我们使用一个尖头剥离器延长了激光创建的通道。11 例连续的圆锥角膜患者接受了治疗，所有手术均成功完成了 DALK。8 只眼（73%）形成了大泡。在 3 例（27%）中，术中发生微小穿孔，手术通过徒手剥离完成，无并发症。这种飞秒激光技术的新应用可能会使 DALK 中的大泡技术标准化。
