scholarly journals Late Detachment after DALK in a Patient with Descemet Membrane Microperforation

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000010
Author(s):  
Marilia Lordello Passos ◽  
Vinicius Coral Ghanem ◽  
André Luís Piccinini ◽  
Ramon Coral Ghanem
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
History Of

We report a case of late detachment in a patient with Descemet membrane (DM) microperforation following a deep anterior lamellar keratoplasty (DALK). Late detachment of the DM in this case occurred 5 months after DALK because of the flattening pressure during the retinal exam with scleral depression. In patients with a history of microperforation during DALK, we suggest that the retinologist and patient avoid rubbing or applying pressure over the eye to minimize the risk of late detachment of the DM.

scholarly journals ‘Double Bubble’ Technique for Successful Reattachment of Total Descemet Membrane Detachment after Deep Anterior Lamellar Keratoplasty

2018 ◽  
Vol 10 (2) ◽  
pp. 180-183 ◽  
Author(s):  
Jeewan S. Titiyal ◽  
Manpreet Kaur ◽  
Sana Tinwala ◽  
Ruchita Falera
Keyword(s):  
Anterior Chamber ◽  
Air Injection ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Air Bubbles ◽  
Double Bubble ◽  
Air Bubble ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
Descemet Membrane Detachment

Background: A double anterior chamber may be observed after deep anterior lamellar keratoplasty (DALK) and the management may be difficult especially in cases with a total descemet membrane detachment (DMD). Case Observations: We describe a novel “reverse double bubble” surgical technique for safe and effective reattachment of  total DMD following DALK. Total DMD with air bubble in the interface was noted on the first postoperative day following DALK for healed keratitis. Intracameral air was injected via a 30-gauge needle inserted through a partial thickness MVR entry made at the posterior limbus, without disturbing the interface air-bubble. During this maneuver, the interface bubble did not change in size and moved towards the centre. The two distinct air bubbles, one in interface and other in anterior chamber indicated that air injection was in the anterior chamber, as per the reverse double bubble technique. The interface air bubble was removed by gently milking with an iris repositor towards the end of surgery. Thus, successful reattachment of DM was achieved despite difficult assessment of the plane of injection with the DM lying fl at on the surface of the iris. Conclusion: The reverse double bubble technique aids in the safe and successful reattachment of total DMD following intraocular surgeries.

scholarly journals Descemetic and Predescemetic DALK in Keratoconus Patients: A Clinical and Confocal Perspective Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Domenico Schiano-Lomoriello ◽  
Rossella Annamaria Colabelli-Gisoldi ◽  
Mario Nubile ◽  
Francesco Oddone ◽  
Giorgio Ducoli ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Layer By Layer ◽  
In Vivo Confocal Microscopy ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
A Minor ◽  
Big Bubble

Purpose. To evaluate the clinical outcomes and in vivo confocal microscopy (IVCM) features of keratoconus patients who underwent deep anterior lamellar keratoplasty (DALK).Methods. DALK was performed using the big bubble technique in all the patients. If the bubble was not successful to bare the descemet membrane, a manual dissection layer-by layer was performed to expose a deep stromal plane close to the DM. The patients were divided in two groups depending on the intraoperative baring of the descemet membrane: predescemetic DALK (PD-DALK) and descemetic DALK (D-DALK) group.Results. One month after surgery the D-DALK patients show an increase of mean BCVA. In the PD-DALK group mean BCVA did not show significant improvement as compared to preoperative values. At 6 months after surgery mean BCVA was found to be similar in both groups. At 1 month IVCM the peak of reflectivity of the interface was lower in D-DALK group compared to PD-DALK. At 6 months the values of reflectivity were comparable.Conclusions. At 1 month D-DALK seems to lead to a minor interface reflectivity and to a better BCVA; these differences disappear after 6 months and the values of interface reflectivity and BCVA are comparable between D-DALK and PD-DALK.

Descemet Membrane Endothelial Keratoplasty for Failed Deep Anterior Lamellar Keratoplasty

Cornea ◽  
2018 ◽  
Vol 37 (6) ◽  
pp. 682-686 ◽  
Author(s):  
Adi Einan-Lifshitz ◽  
Nir Sorkin ◽  
Tanguy Boutin ◽  
Zale Mednick ◽  
Mohammad Kreimei ◽  
...  
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty
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