title: Internal view of the effects of the big-bubble technique during experimental deep anterior lamellar keratoplasty.
abstract: OBJECTIVE
  To determine how the air bubble dissects Descemet membrane from the inside during experimental deep lamellar anterior keratoplasty.
  
  
  METHODS
  In this experimental study, 4 corneas from enucleated human eyes were dissected and placed in an artificial anterior chamber. Air was injected through a 27-gauge needle into the midperiphery without previous trephination until a big bubble formed. The results were photographed from the inside.
  
  
  RESULTS
  The edge of the air dissection was viewed clearly. The dissection was not uniform; one side was dissected more than the other. Descemet membrane and the stroma may still have been attached. The results provided a clue about why perforation frequently occurs when dissecting the anterior lamella in the periphery.
  
  
  CONCLUSIONS
  As much air as possible should be injected. Premature cessation of the injection of air can result in irregular dissection by all edges of the bubble or an incomplete bubble.
authors.affiliation: Department of Cornea and Ocular Surface, Institut Catala de la Retina, Barcelona, Spain. jgatell@comb.cat
authors.forename: Jordi
authors.initials: J
authors.lastname: Gatell
mesh_terms: D000388:Air; D003319:Corneal Stroma / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D004724:Endoscopy; D058450:Endotamponade; D006801:Humans