Anterior Segment Department, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Eye (Lond). 2011 Jun;25(6):803-8. doi: 10.1038/eye.2011.72. Epub 2011 Apr 8.
To describe a new technique for performing maximum-depth anterior lamellar keratoplasty.
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.
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.
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.
描述一种进行最大深度前板层角膜移植术的新技术。
这是一项使用新方法的病例系列研究。我们介绍并描述了一个新的标志（阳光向上标志），该标志揭示了在角膜基质（DM）-基质界面处气泡的存在和范围。我们还报告了一种新的技术，通过向气泡腔注射粘性物质来扩大气泡，并在环钻区域内几乎完全切除基质组织。随访时间为 12 至 16 个月。在所有患者中，我们记录了术前和术后最佳矫正视力、角膜曲率计和内皮细胞计数，以及使用阳光向上标志测量的气泡直径。
在 9 例患者中有 8 例形成了大的气泡。气泡的大小范围从 2 到 7 毫米。所有气泡均扩大至 8 毫米，并且在所有情况下都获得了整个环钻区域的裸露 DM。术后平均角膜曲率读数与术前平均角膜曲率读数相比有所降低。与术前视力相比，术后 BSCVA 增加。术前和术后内皮细胞计数之间的差异无统计学意义。
在使用膨胀气泡技术的系列中，早期结果表明，该技术在进行最大深度前板层角膜移植术中是安全且简单的。
