title: Residual corneal stroma in big-bubble deep anterior lamellar keratoplasty: a histological study in eye-bank corneas.
abstract: OBJECTIVE
  To determine if residual corneal stroma remains on the recipient posterior lamella in big-bubble deep anterior lamellar keratoplasty (DALK).
  
  
  METHODS
  Pneumodissection using the big-bubble technique was carried out on eye-bank corneas mounted on an artificial anterior chamber. Samples that had a successful big-bubble formation were sent for histological evaluation to determine if any residual stroma remained on the Descemet membrane (DM).
  
  
  RESULTS
  Big-bubble formation was achieved in 32 donor corneas. Two distinct types of big-bubble were seen: the bubble had either a white margin (30 corneas) or a clear margin (two corneas). The posterior lamellae of all the white margin corneas showed residual stroma on DM with a mean central thickness of 7.0 μm (range 2.6-17.4 μm). The clear margin corneas showed no residual stroma on DM.
  
  
  CONCLUSIONS
  It should no longer be assumed that big-bubble DALK, where the bubble has a white margin, routinely bares DM. True baring of DM may only occur with the less commonly seen clear margin bubble.
authors.affiliation: Manchester Royal Eye Hospital, Manchester, UK. hamishmckee@gmail.com
authors.forename: Hamish D
authors.initials: HD
authors.lastname: McKee
authors.forename: Luciane C D
authors.initials: LC
authors.lastname: Irion
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Carley
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Arun K
authors.initials: AK
authors.lastname: Brahma
mesh_terms: D003319:Corneal Stroma / Q000473:pathology*; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery; D005125:Eye Banks; D006801:Humans; D009924:Organ Culture Techniques