Abstract
Abstract Purpose To evaluate visual outcomes following Anwar's 'Big Bubble' technique for deep anterior lamellar keratoplasty (DALK) Methods Retrospective Case note review of all patients who were treated with DALK in a single university teaching hospital in the UK between January 2004 and December 2007. The main outcome measures were intra operative and postoperative complications, graft clarity and best corrected visual acuity. Results The study group consisted of 37 eyes of 36 patients (21 male, 15 female). Average age of the cohort was 34.5 years (range: 16 ‐‐ 65), with a mean follow‐up of 20.4 months (range: 6 ‐‐ 46) Keratoconus was the most common indication for attempted DALK (65%). Big bubble was achieved in 62% of cases with microperforations in 14%. A further 14% needed to have manual dissection. Clear Graft Host interface was achieved in 87% of cases where the big bubble was achieved and 76% gained best corrected visual acuity (BCVA) of >6/12. Conclusion DALK offers visual outcomes similar to that of a penetrating keratoplasty and should be offered to all patients with a healthy endothelium undergoing corneal transplantation.
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