Manchester Royal Eye Hospital, Manchester, United Kingdom.
Cornea. 2013 Apr;32(4):520-2. doi: 10.1097/ICO.0b013e318257f7aa.
During big-bubble deep anterior lamellar keratoplasty, a bubble that is not large enough can be formed. Further air injection can result in the rupture of the posterior lamella, necessitating conversion to penetrating keratoplasty. We describe some techniques to safely enlarge the big-bubble in such a circumstance.
In cases in which a white-margin bubble forms that has extended to the trephination margin, the bubble is collapsed and the margins are extended by blunt dissection. For cases of an undersized clear-margin bubble, the bubble is enlarged by gentle injection of a cohesive ophthalmic viscosurgical device into the bubble cavity.
Using these techniques, big-bubbles were safely extended beyond the trephination margin for both white- and clear-margin bubbles.
An undersized big-bubble can safely be extended using blunt dissection for white-margin bubbles and ophthalmic viscosurgical device injection for clear-margin bubbles.
在大泡深层前板层角膜移植术中，可能会形成不够大的气泡。进一步注入空气会导致后板层破裂，需要转为穿透性角膜移植术。我们描述了一些在这种情况下安全扩大大泡的技术。
在已经延伸到环钻边缘的白色边缘气泡形成的情况下，通过钝性剥离使气泡塌陷并扩展边缘。对于小尺寸的透明边缘气泡，通过向气泡腔内轻轻注入粘性眼科粘弹剂来扩大气泡。
使用这些技术，白色和透明边缘的大泡都可以安全地扩展到环钻边缘之外。
对于白色边缘的气泡，可以通过钝性剥离安全地扩展小尺寸的大泡，对于透明边缘的气泡，可以通过眼科粘弹剂注射来扩展。
