Dissection plane in deep anterior lamellar keratoplasty using the big-bubble technique
Abstract
Purpose To find the level of dissection in keratoconic corneas undergoing deep anterior lamellar keratoplasty (DALK) using the big-bubble technique. Methods In 3 keratoconic eyes that underwent DALK, the operation was converted into penetrating keratoplasty after complete big-bubble formation because of extensive tear in Descemet's membrane (DM) during stromal excision. The corneal stroma and DM taken from these eyes were submitted for light and transmission electron microscopy. Results Both light and transmission electron microscope revealed a thin layer of corneal stroma adhered to DM in all cases. In 2 eyes, the residual stromal thickness was almost constant (6.4 μm and 12.3 μm), whereas it varied from 9.5 μm to 25.8 μm in the other one. Conclusion Dissection plane in DALK using the big-bubble technique can be within corneal stroma rather than exactly between stroma and DM. Various corneal pathologies as well as different techniques of dissection may have influence on this level.
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When a so-called big bubble is induced during pneumodissection, part of the posterior stroma often adheres to Descemet's membrane, indicating a natural cleavage plane in the stroma about 10 μm above Descemet's membrane.
“when a so-called “big bubble” is induced, part of the posterior stroma often adheres to the Descemet's membrane, and that there is, therefore, a natural cleavage plane in the stroma about 10 μm above Descemet's membrane (Jafarinasab et al., 2010, McKee et al., 2011).”
From Corneal structure and transparency (2015) · cites this paper as Jafarinasab et al., 2010
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Corneal structure and transparency
Meek, K. M., & Knupp, C. (2015) · Progress in Retinal and Eye Research · doi:10.1016/j.preteyeres.2015.07.001 · Cited by 853 · see citing works
- Authors
- Jafarinasab, M. R., Rahmati-Kamel, M., Kanavi, M. R., & Feizi, S.
- Affiliations
- Hospital Labbafinejad (IR)
- Venue
- Cornea
- Published
- 2010-04
- Volume
- 29
- Issue
- 4
- Pages
- 388-391
- ISSN
- 0277-3740 (ISSN-L)
- OpenAlex
- W1972397860
- Cited by
- 57
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 9 · 2014: 6 · 2013: 2 · 2012: 6
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cornea (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Corneal surgery and disorders
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Corneal Surgery and Treatments
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Keywords
- deep anterior lamellar keratoplasty, big bubble technique, dissection plane, keratoconus, Descemet's membrane, corneal stroma, residual stromal thickness
- MeSH terms
- Adult, Corneal Stroma, Descemet Membrane, Dissection, Humans, Keratoconus, Keratoplasty, Penetrating, Corneal Transplantation, Young Adult
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