Big bubble deep anterior lamellar keratoplasty: the collagen layer in the wall of the big bubble is unique. (30th March 2015)

• Record Type: Journal Article
• Authors: Dua, Harminder S.; Mastropasqua, Leonardo; Faraj, Lana; Nubile, Mario; Elalfy, Mohamed S.; Lanzini, Manuela; Calienno, Roberta; Said, Dalia G.
• Is Part Of: Acta ophthalmologica. Volume 93:Number 5(2015)
• Page Start: 427
• Page End: 430
• Publication Date: 2015-03-30
• Subjects: Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.12714
• Languages: English
• ISSNs: 1755-375X

Abstract

<abstract abstract-type="main" id="aos12714-abs-0001"> <title>Abstract</title> <sec id="aos12714-sec-0001" sec-type="section"> <title>Purpose</title> <p>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.</p> </sec> <sec id="aos12714-sec-0002" sec-type="section"> <title>Methods</title> <p>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<italic>μ</italic> 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.</p> </sec> <sec id="aos12714-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="aos12714-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>