EXPORT CITATION

Chapter-25 Deep Anterior Lamellar Keratoplasty: Double Bubble Technique

BOOK TITLE: Corneal Transplantation

Author
1. Vajpayee Rasik B
2. Jhanji Vishal
3. Sharma Namrata
4. Beltz Jacqueline
ISBN
9788184488593
DOI
10.5005/jp/books/11167_25
Edition
2/e
Publishing Year
2010
Pages
5
Author Affiliations
1. Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, RP Center of Ophthalmology, AIIMS, Ansari Nagar, New Delhi 110 029, India, Vision Eye Institute, Melbourne, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Centre for Eye Research Australia, University of Melbourne, Australia, All India Institute of Medical Sciences, RP Center, New Delhi, India, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia, Cornea Services Royal Victorian Eye and Ear Hospital, Centre for Eye Research, University of Melbourne, Australia, RP Center of Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Me
2. Clinical Co-Director of the Funderburgh, Corneal Regeneration Project, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Refractive Surgery Service, Clinical Co-Director of the Funderburgh, Corneal Regeneration Project, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA, Cornea Services Royal Victorian Eye and Ear Hospital, Melbourne, Australia, The Chinese University of Hong Kong, Hong Kong, The Chinese University of Hong Kong Hong KongShekhar, The Chinese University of Hong Kong Hong Kong, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Mongkok Kowloon, Hong Kong, Dr RP Center for Ophthalmic Sciences, AIIMS, New Delhi, Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, Clinical Ophthalmology, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, In
3. All India Institute of Medical Sciences (AIIMS), New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
4. Royal Victorian Eye and Ear Hospital, Melbourne, Australia, Royal Victorian Eye and Ear Hospital Melbourne, VIC Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia, Cornea Services Royal Victorian Eye and Ear Hospital, Melbourne, Australia, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
Chapter keywords

Abstract

Our technique of “Double Bubble” DALK is a simple and effective surgery that helps in the recognition of the big bubble during air injection into the corneal stroma. This further helps in the successful performance of DALK in corneal stromal disorders sparing the Descemet’s membrane. Deep anterior lamellar keratoplasty is a technique of corneal transplantation that entails the replacement of diseased host corneal stroma without replacing the healthy endothelium. The procedure eliminates the risk of corneal endothelial graft rejection and other inherent complications related to full-thickness corneal transplantation surgery. Double bubble DALK in which a small amount of air is injected into the AC before the injection of air into the cornea stroma. As soon as a big bubble is formed, there is a sudden peripheral movement of the air from the center of the AC due to the inward bulging of DM. Being a dynamic sign, this sudden movement of the small bubble is easily appreciated by the surgeon. Also, the decompression of the AC prior to the injection of the small bubble reduces the resistance offered by the cornea of an intact eye and allows space for the DM to bulge inward on formation of the big bubble.

© 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved