Air pressure changes in the creation and bursting of the type-1 big bubble in deep anterior lamellar keratoplasty: an ex vivo study
AlTaan, S.L.; Mohammed, I.; Said, D.G.; Dua, H.S.
HARMINDER DUA HARMINDER.DUA@NOTTINGHAM.AC.UK
Professor of Ophthalmology and Visual Sciences
Purpose: To measure the pressure and volume of air required to create a big bubble (BB) in simulated deep anterior lamellar keratoplasty (DALK) in donor eyes and ascertain the bursting pressure of the BB.
Patients and methods: Twenty-two human sclera-corneal discs were used. Air was injected into the corneal stroma to create a BB and the pressure measured by means of a pressure converter attached to the system via a side port. A special clamp was designed to prevent air leak from the periphery of the discs. The pressure at which air emerged in the corneal tissue; the bursting pressure measured after advancing the needle into the bubble cavity and injecting more air; the volume of air required to create a BB and the volume of the BB were ascertained.
Results: Type-1 BB were achieved in 19 and type-2 BB in 3 eyes. The maximum pressure reached to create a BB was 96.25+/- 21.61?kpa; the mean type-1 intrabubble pressure was 10.16 +/- 3.65?kpa. The mean bursting pressure of a type-1 BB was 66.65 +/- 18.65?kpa, while that of a type-2 BB was 14.77 +/- 2.44?kpa. The volume of air required to create a type-1 BB was 0.54?ml and the volume of a type-1 BB was consistently 0.1?ml.
Conclusions: Dua's layer baring DALK can withstand high intraoperative pressures compared to Descemet's membrane baring DALK. The study suggests that it could be safe to undertake procedures such as DALK-triple with a type-1 BB but not with a type-2 BB.
AlTaan, S., Mohammed, I., Said, D., & Dua, H. (2018). Air pressure changes in the creation and bursting of the type-1 big bubble in deep anterior lamellar keratoplasty: an ex vivo study. Eye, 32(1), 146-151. https://doi.org/10.1038/eye.2017.121
|Journal Article Type||Article|
|Acceptance Date||May 4, 2017|
|Online Publication Date||Jun 30, 2017|
|Publication Date||Jan 30, 2018|
|Deposit Date||Nov 16, 2018|
|Publicly Available Date||Nov 19, 2018|
|Publisher||Nature Publishing Group|
|Peer Reviewed||Peer Reviewed|
25558 1 Merged 1490872071
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