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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.

Authors

S.L. AlTaan

D.G. Said

HARMINDER DUA HARMINDER.DUA@NOTTINGHAM.AC.UK
Professor of Ophthalmology and Visual Sciences



Abstract

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.

Citation

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
Journal Eye
Print ISSN 0950-222X
Electronic ISSN 1476-5454
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 32
Issue 1
Pages 146-151
DOI https://doi.org/10.1038/eye.2017.121
Public URL https://nottingham-repository.worktribe.com/output/1277103
Publisher URL https://www.nature.com/articles/eye2017121

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