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- Title
Big bubble deep anterior lamellar keratoplasty: the collagen layer in the wall of the big bubble is unique.
- Authors
Dua, Harminder S.; Mastropasqua, Leonardo; Faraj, Lana; Nubile, Mario; Elalfy, Mohamed S.; Lanzini, Manuela; Calienno, Roberta; Said, Dalia G.
- Abstract
Purpose In big bubble ( BB), deep anterior lamellar keratoplasty intracorneal injection of air separates Descemet's membrane ( DM) and the pre-Descemet's layer (Dua's layer [ DL]) to create a type 1 BB. We tested the hypothesis that air injection after excision or ablation of DL will fail to produce a BB. Methods Nine human sclero-corneal discs were used. Three served as controls. In three, a type 1 BB was created, the bubble wall was excised and more air injected in an attempt to create another BB. In three samples, the DM was removed and 22 μ of posterior cornea were ablated by phototherapeutic keratectomy ( PTK). Air was injected to induce formation of a BB. Tissue from these experiments was subjected to light and electron microscopy. Results In all three control eyes, a type 1 BB ( DL + DM) was obtained. Air injection after excision of the type 1 BB wall in three samples failed to produce another BB. Following PTK of DL, injection of air failed to create a BB in all three samples. Multiple points of air leak from the deep stroma were observed in all six samples. Light and electron microscopy showed a clear distinction between the ablated and non-ablated areas of cornea. Conclusions This study supports the hypothesis that a BB cannot be created once the DL is excised or ablated. This adds to evidence that DL is unique. It also demonstrates that DL is not a random separation of deep stroma of the cornea.
- Subjects
CORNEA surgery; COLLAGEN; SURGICAL excision; INJECTIONS; ELECTRON microscopy; EXPERIMENTS
- Publication
Acta Ophthalmologica (1755375X), 2015, Vol 93, Issue 5, p427
- ISSN
1755-375X
- Publication type
Article
- DOI
10.1111/aos.12714