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  • Title: "Large-bubble" modification of the "big-bubble" technique for performing maximum-depth anterior lamellar keratoplasty.
    Author: Behrooz MJ, Daneshgar F.
    Journal: Cornea; 2010 Jul; 29(7):820-4. PubMed ID: 20489589.
    Abstract:
    PURPOSE: To describe a new technique for performing maximum-depth anterior lamellar keratoplasty. METHODS: This was a case series study of a novel method. We combined shallow trephination of the cornea with superficial injection of air in 15 cases. This resulted in formation of a large bubble over Descemet membrane extending to the peripheral cornea. We deflated the bubble at the trephination wound and excised the button from the host completely. The follow-up was from 3 to 8 months. The best spectacle-corrected visual acuity, intraocular pressure, corneal clarity, endothelial cell count, and corneal thickness were recorded preoperatively and 3 and 6 months postoperatively. RESULTS: Successful access to intact bare Descemet membrane was obtained in all but one case, which required conversion to penetrating keratoplasty. All corneas were clear at the end of follow-up. We found a significant difference in the endothelial cell counts in the cases that we compared. The postoperative central corneal thickness increased significantly compared with preoperative levels. CONCLUSION: The early outcomes in our initial series of cases using the "large-bubble" technique suggest that it is a fast effective method.
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