Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran.
School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Ophthalmol. 2023 Sep;33(5):2034-2041. doi: 10.1177/11206721221125293. Epub 2022 Sep 15.
We describe a modified technique for deep anterior lamellar keratoplasty with three modifications in big bubble pneumodissection technique; including two staged stromal trephination to avoid inadvertent full-thickness trephination, deep bevel-up needle air injection for better visualization and deeper air injection and, vicoseperation by refilling the pre-Descemet space with a viscoelastic after removing the air bubble for safe removal of the deep stromal layers. Patients with advanced keratoconus underwent deep anterior lamellar keratoplasty with pneumodissection by two-staged trephination followed by bevel-up needle deep air injection and viscoseperation. The big bubble was successfully formed in all cases and there was no case with the rupture of the Descemet's membrane (DM) during air injection or baring of DM.
我们描述了一种改良的深层前弹力层角膜移植术，在大疱性气动分离技术中有三个改良；包括两次分阶段的基质环钻术，以避免意外的全层环钻术，深斜面向上的针空气注射以获得更好的可视化和更深的空气注射，以及在去除气泡后用粘弹剂填充前 Descemet 空间，以便安全地去除深层基质层，实现粘分离。患有晚期圆锥角膜的患者接受了气动分离的深层前弹力层角膜移植术，采用两阶段环钻术，然后进行斜面向上的针深空气注射和粘分离。所有病例均成功形成大疱，在空气注射或暴露 DM 期间无 DM 破裂的病例。
