title: Technique for air bubble management during endothelial keratoplasty in eyes after penetrating glaucoma surgery.
abstract: Our purpose was to develop a technique for maintaining air within the anterior chamber during endothelial keratoplasty in eyes that have previously undergone trabeculectomy or a glaucoma drainage implant. Whole human globes and rabbits underwent penetrating glaucoma surgery to develop the technique. Without the aid of any additional device or manipulation, continuing to inject air into the anterior chamber as it escapes through the sclerostomy or tube eventually fills the subconjunctival space and allows for back pressure. This allows for a full anterior chamber air fill and brief elevation of intraocular pressure. We employed this overfilling technique on 3 patients with previous incisional glaucoma surgery to perform successful Descemet stripping endothelial keratoplasty without complication. We recommend using the overfilling technique when performing Descemet stripping endothelial keratoplasty surgery in eyes with previous penetrating glaucoma surgery because it is a simple technique without the need for pre- or postoperative manipulation.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA. mbanitt@med.miami.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Banitt
authors.forename: Esdras
authors.initials: E
authors.lastname: Arrieta-Quintero
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Parel
authors.forename: Francisco
authors.initials: F
authors.lastname: Fantes
mesh_terms: D000369:Aged, 80 and over; D000388:Air; D000867:Anterior Chamber; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D014130:Trabeculectomy; D016896:Treatment Outcome