Shifting bubble-guided sutureless technique for performing descemetorhexis for retained Descemet’s membrane after penetrating keratoplasty

Abstract

We describe the use of anterior segment optical coherence tomography in the diagnosis of inadvertent retention of Descemet's membrane (DM) after penetrating keratoplasty, and a novel technique for its removal in a case of congenital hereditary endothelial dystrophy. In this technique, we use a modification of the shifting bubble technique, commonly used in deep anterior lamellar keratoplasty where a viscocohesive ophthalmic viscosurgical device is injected into the false anterior chamber which causes migration of the central air bubble placed in the anterior chamber peripherally and helps in confirming the correct space. The DM is then peeled in a circular fashion with the help of 23-G vitreoretinal micro forceps.