Ophthalmic viscosurgical device-assisted incision modification for the big-bubble technique in deep anterior lamellar keratoplasty.
We describe several simple modifications of the big-bubble technique to improve surgeon comfort and reduce the risk for complications, with emphasis on our ophthalmic viscosurgical device (OVD)-assisted incision technique. By coating the overlying stroma with OVD prior to entering the big bubble, space is maintained in the pre-Descemet plane. This prevents collapse of the big bubble and allows an air-OVD exchange. We have successfully used this technique in 72 consecutive cases without a perforation during the entry incision to the bubble space of the DALK procedure.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
Devers Eye Institute, Portland, Oregon 97210, USA.
Jeffrey
J
Goshe
Mark A
MA
Terry
Neda
N
Shamie
Jennifer
J
Li
D016039:Corneal Transplantation / Q000379:methods*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007431:Intraoperative Complications / Q000517:prevention & control; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D055675:Viscosupplements / Q000008:administration & dosage*
D009883:Ophthalmic Solutions; D055675:Viscosupplements; D006820:Hyaluronic Acid