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J Cataract Refract Surg. 2002 Mar;28(3):398-403.

Big-bubble technique to bare Descemet's membrane in anterior lamellar keratoplasty.

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El Maghrabi Eye & Ear Hospital, Jeddah, Saudi Arabia.


We describe a lamellar keratoplasty technique to bare Descemet's membrane in which air is injected to detach the central Descemet's. After a partial-thickness corneal trephination is performed, a disposable needle is inserted, deeply and bevel down, into the paracentral corneal stroma and air is injected. In most cases, this forms a large air bubble between Descemet's membrane and the corneal stroma. After anterior lamellar keratectomy is performed, a small opening is made in the air bubble and the remaining stromal layers are lifted with an iris spatula, severed with a blade, and excised with scissors. This technique is faster, safer, and easier to perform than previous methods.

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