Modification of the Miyake–Apple Technique for Simultaneous Anterior and Posterior Video Imaging of Wet Laboratory–Based Corneal Surgery

Abstract

The aim of this study was to describe a modification of the Miyake-Apple posterior video analysis for the simultaneous visualization of the anterior and posterior corneal surfaces during wet laboratory-based deep anterior lamellar keratoplasty (DALK). A human donor corneoscleral button was affixed to a microscope slide and placed onto a custom-made mounting box. A big bubble DALK was performed on the cornea in the wet laboratory. An 11-diopter intraocular lens was positioned over the aperture of the back camera of an iPhone. This served to video record the posterior view of the corneoscleral button during the big bubble formation. An overhead operating microscope with an attached video camcorder recorded the anterior view during the surgery. The anterior and posterior views of the wet laboratory-based DALK surgery were simultaneously captured and edited using video editing software. The formation of the big bubble can be studied. This video recording camera system has the potential to act as a valuable research and teaching tool in corneal lamellar surgery, especially in the behavior of the big bubble formation in DALK.