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SURGICAL TECHNIQUE
Year : 2011  |  Volume : 6  |  Issue : 1  |  Page : 66-68

A Technique to Salvage Big-Bubble Deep Anterior Lamellar Keratoplasty after Inadvertent Full-Thickness Trephination


Eye Research Center and Department of Ophthalmology, Khatam-al-Anbia Eye Hospital Mashhad University of Medical Sciences, Mashhad, Iran

Correspondence Address:
Siamak Zarei-Ghanavati
Assistant Professor of Ophthalmology, Eye Research Center and Department of Ophthalmology, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Abootaleb Blvd, Mashhad 91869
Iran
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Source of Support: None, Conflict of Interest: None


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Herein we describe a technique for management of large inadvertent full-thickness trephination during deep anterior lamellar keratoplasty using the big-bubble technique without converting to penetrating keratoplasty. First, the anterior chamber is formed with an ophthalmic viscosurgical device (OVD). Then, the full-thickness wound is secured with one X-type 10-0 nylon suture. A 27-gauge needle is attached to a 2 ml air-filled syringe and inserted into the corneal stroma in the meridian opposite to the site of full-thickness trephination. Air is gently injected to produce a limited area of "big-bubble" detaching Descemet's membrane (DM) from the corneal stroma. The "big bubble" is slowly expanded with injection of OVD. Finally, the recipient stroma is removed, the donor lenticule is placed and the DM tear is secured with one full thickness 10-0 nylon suture.


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