Andrew R Ross
Deep anterior lamellar keratoplasty: dissection plane with viscoelastic and air can be different
Ross, Andrew R; Said, Dalia G; El-Amin, Abdalla; Altaan, Saif; Cabrerizo, Javier; Nubile, Mario; Hogan, Emily; Mastropasqua, Leonardo; Dua, Harminder Singh
Authors
Dalia G Said
Abdalla El-Amin
Saif Altaan
Javier Cabrerizo
Mario Nubile
Emily Hogan
Leonardo Mastropasqua
HARMINDER DUA HARMINDER.DUA@NOTTINGHAM.AC.UK
Professor of Ophthalmology and Visual Sciences
Contributors
HARMINDER DUA HARMINDER.DUA@NOTTINGHAM.AC.UK
Supervisor
Abstract
Aims: To investigate and define the nature of big bubbles (BB) formed by injection of viscoelastic in deep anterior lamellar keratoplasty.
Methods: Intrastromal injections of 0.1 and 0.3 mL of sodium hyaluronate 1.2% and 0.6% were made into sclera-corneal discs (n = 32) at superficial (anterior-third), midstromal (middle-third) and deep (posterior-third) levels to simulate deep anterior lamellar keratoplasty. Postinjection optical coherence tomograms (OCT) were obtained with the needle in situ. The samples were sectioned and examined histologically. Twelve control samples were injected with air.
Results: With superficial injections (n=8) only intrastromal accumulation of viscoelastic was noted. With midstromal injections (n=10) intrastromal accumulation of viscoelastic (n=6) and intrastromal big bubbles (IBB) (n=4) with substantial and variable stromal tissue in the walls were noted. No type 1, type 2 or mixed BB were noted. With deep injections (n=14), type 1 BB (n=4), IBB (n=4) and mixed BB (n=6) were obtained.
There was no difference in the results with the two different concentrations of viscoelastic used. With air injection (n=12), 10 type 1 and 1 type 2 BB and 1 mixed BB were obtained. No IBB was noted.
Conclusions: BB obtained by injection of viscoelastic and air can be different. The former tends to occur at the site of injection, especially with midstromal injections, takes the form of tissue separation by stretch and tearing and does not cleave in a consistent plane like air. Surgeons should be aware of IBB created by viscodissection and not confuse it for a type1 BB. Intraoperative OCT should help identify IBB.
Citation
Ross, A. R., Said, D. G., El-Amin, A., Altaan, S., Cabrerizo, J., Nubile, M., …Dua, H. S. (2018). Deep anterior lamellar keratoplasty: dissection plane with viscoelastic and air can be different. British Journal of Ophthalmology, 102(12), 1646-1652. https://doi.org/10.1136/bjophthalmol-2017-311349
Journal Article Type | Article |
---|---|
Acceptance Date | Jan 27, 2018 |
Online Publication Date | Apr 3, 2018 |
Publication Date | 2018-12 |
Deposit Date | Jun 10, 2019 |
Journal | British Journal of Ophthalmology |
Print ISSN | 0007-1161 |
Electronic ISSN | 1468-2079 |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 102 |
Issue | 12 |
Pages | 1646-1652 |
DOI | https://doi.org/10.1136/bjophthalmol-2017-311349 |
Public URL | https://nottingham-repository.worktribe.com/output/2165699 |
Publisher URL | https://bjo.bmj.com/content/102/12/1646 |
You might also like
Nerve terminals at the human corneoscleral limbus
(2017)
Journal Article
Survival of corneal nerve/sheath structures in organ-cultured donor corneas
(2017)
Journal Article
Scrolling Characteristics of Pre-Descemet Endothelial Keratoplasty Tissue: An Ex Vivo Study
(2016)
Journal Article
Clinical evaluation and characterisation of corneal vascularisation
(2015)
Journal Article
Downloadable Citations
About Repository@Nottingham
Administrator e-mail: discovery-access-systems@nottingham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search