Outcomes of Air Injection Within 2 mm Inside a Deep Trephination for Deep Anterior Lamellar Keratoplasty in Eyes With Keratoconus

American Journal of Ophthalmology
Massimo BusinYoav Nahum

Abstract

To evaluate the outcomes of a new technique for deep anterior lamellar keratoplasty (DALK) employing the injection of air up to 2 mm inside a deep trephination (intended within 100 μm from the endothelial surface) obtained with a guarded trephine set by means of anterior segment optical coherence tomography (AS OCT). Retrospective, noncomparative, interventional case series. The success rate and learning curve of pneumatic dissection in one clinical practice were analyzed in nonscarred keratoconic eyes undergoing a standardized DALK including 9-mm trephination intended to a depth within 100 μm from the endothelial surface, based on the thinnest AS OCT measurement at this site; and injection of air through a cannula advanced 1-2 mm centripetally from the bottom of the trephination. Surgical parameters, success rate of pneumatic dissection, and complications were recorded. Eighty-eight eyes of 88 patients were included in the study. Pneumatic dissection succeeded in 75 of 88 eyes (85%). No significant correlation could be found between number of cases performed and success rate for this surgeon. Complications included loss of suction during trephination (n = 2, 2.3%) and perforation (n = 4, 4.6%). Conversion to penetrating kerato...Continue Reading

References

Apr 26, 2002·Journal of Cataract and Refractive Surgery·Mohammed Anwar, Klaus D Teichmann
Jul 26, 2005·American Journal of Ophthalmology·Massimo Busin, Robert C Arffa
Sep 23, 2009·Cornea·Vincenzo SarnicolaSadeer B Hannush
Jun 30, 2010·The British Journal of Ophthalmology·Tiarnan D L KeenanUNKNOWN NHSBT Ocular Tissue Advisory Group and contributing ophthalmologists (OTAG Audit Study 8)
Nov 28, 2012·Ophthalmology·Vincenzo ScorciaGiovanni Scorcia
May 30, 2013·Ophthalmology·Harminder S DuaJames Lowe
Dec 9, 2014·American Journal of Ophthalmology·Vito RomanoLuigi Fontana

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Citations

May 16, 2020·Current Opinion in Ophthalmology·Angeli Christy YuMassimo Busin
Dec 1, 2021·Clinical & Experimental Ophthalmology·Marco PellegriniMassimo Busin

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