Histopathology of deep anterior lamellar keratoplasty with pneumatic dissection: the "big-bubble" technique.
OBJECTIVE
To describe characteristic histopathologic markers in deep anterior lamellar keratoplasty (DALK) using pneumatic dissection: Anwar "big-bubble" technique.


METHODS
Case reports. Deep stromal buttons from 2 patients with keratoconus who had undergone DALK surgery using the "big-bubble" technique were examined by light microscopy.


RESULTS
The histopathology of excised corneal buttons demonstrated multiple intrastromal spaces consistent with air bubbles. Apical stromal thinning seen clinically was not as readily appreciated on histopathology.


CONCLUSIONS
Pneumatic dissection in DALK produces diffuse intrastromal air bubbles that may mask the corneal thinning that usually characterizes keratoconus histopathologically. This is a characteristic finding of which ocular pathologists and corneal surgeons should be aware.
Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA 95817, USA.
Pauline
P
Lim
Jay C
JC
Bradley
George J
GJ
Harocopos
Morton E
ME
Smith
Mark J
MJ
Mannis
D000293:Adolescent; D000388:Air; D003315:Cornea / Q000473:pathology*; D003319:Corneal Stroma / Q000473:pathology; D016039:Corneal Transplantation / Q000379:methods*; D004210:Dissection / Q000379:methods*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008863:Microspheres; D008875:Middle Aged