Femtosecond laser–assisted big bubble for deep anterior lamellar keratoplasty

Abstract

Purpose: 

To assess the utility of a femtosecond laser–assisted stromal channel to assist the creation of a big bubble (BB) for deep anterior lamellar keratoplasty (DALK) surgery in cadaveric corneas.

Setting: 

L V Prasad Eye Institute, Hyderabad, India.

Design: 

Experimental study.

Methods: 

An attempt to create a BB was made on 10 donor pairs of human cadaveric corneoscleral tissues. The 20 corneas were split into 2 groups: Group A underwent femtosecond laser pretreatment and Group B had conventional manual deep lamellar technique. Laser pretreatment was performed using the VisuMax femtosecond laser system to create a stromal channel using the intracorneal ring segment treatment module for direct insertion of the 27-gauge air cannula for pneumodissection at a predetermined depth.

Results: 

Of the 20 corneas studied, type 1 BB was achieved in 9 of 10 corneas in Group A and in 7 of 10 corneas in Group B. One cornea from Group A had a combined type 1 and 2 BB, whereas no BB was achieved in 1 cornea.

Conclusions: 

Creation of an intrastromal channel using a femtosecond laser at a predetermined depth seemed to be a promising option to increase the chances of achieving a BB when compared with the conventional air injection technique of BB DALK.

In Brief

New method of big-bubble formation for facilitating baring of Descemet membrane/pre-Descemet membrane by using a femtosecond intrastromal corneal channel for deep anterior lamellar keratoplasty.