Double bubble technique in deep lamellar keratoplasty surgery

Abstract

Objective To evaluate the effectiveness of double-bubble technique in deep lamellar keratoplasty.Methods Small air bubbles were injected into anterior chamber for a guide before injection of large air bubbles within the matrix to separate Descemet's membrane in 35 patients (37 eyes)of normal endothelial function with corneal diseases.Then,the best corrected visual acuity and complications were observed,and the surgical techniques were analyzed at last.Results The Descemet's membrane of 30 eyes (81.1％) were successfully separated by double-bubble technique,5 eyes (13.5％)were also achieved success with microperforation of the Descemet's membrane,2 eyes (5.4％) were diverted to penetrating keratoplasty due to large range of perforation of the Descemet's membrane.The mean postoperative best corrected visual acuity was 0.47± 0.17 (0.1～0.8) in follow-up of 6 to 18(mean 12.3) months.The false anterior chamber (layer separation) of 4 eyes (10.8％) were cured by injection of air bubbles to the appropriate pressure,3 eyes (8.1％) of hormone-related elevation of intraocular pressure and 4 eyes (10.8％) of immune rejection were all cured by drug treatment.Conclusions Double-bubble technique can significantly improve the success rate of corneal Descemet's membrane separation and can shorten the operative time and improve the quality of operation.Double-bubble technique is a kind of safe and effective surgical technique on deep lamellar keratoplasty. Key words: Double-bubble technique; Keratoplasty; The Descemet's membrane