Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus

Mohamed Bahgat Goweida,1,2 Amr Abuelkheir,1,2 Wael Abdel Rahman El-Menawy,1,2 Shahira Mahmoud1,2 1Department of Ophthalmology, Alexandria Main, University Hospital, Alexandria, Egypt; 2Faculty of Medicine, Alexandria University, Alexandria, EgyptCorrespondence: Shahira Mahmoud 4th Ghanem Abd El- Reh...

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Autores principales:	Goweida MB, Abuelkheir A, El-Menawy WAR, Mahmoud S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	dalk type 2 big bubble descemet’s membrane. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/1a061993645b4ff495a153e19ea8f9e7
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spelling	oai:doaj.org-article:1a061993645b4ff495a153e19ea8f9e72021-12-02T15:10:13ZDynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus1177-5483https://doaj.org/article/1a061993645b4ff495a153e19ea8f9e72020-12-01T00:00:00Zhttps://www.dovepress.com/dynamics-of-big-bubble-formation-during-deep-anterior-lamellar-keratop-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mohamed Bahgat Goweida,1,2 Amr Abuelkheir,1,2 Wael Abdel Rahman El-Menawy,1,2 Shahira Mahmoud1,2 1Department of Ophthalmology, Alexandria Main, University Hospital, Alexandria, Egypt; 2Faculty of Medicine, Alexandria University, Alexandria, EgyptCorrespondence: Shahira Mahmoud 4th Ghanem Abd El- Reheem Street, Fleming, Alexandria, EgyptTel +201229557131Email Shahira.rashad@alexmed.edu.egPurpose: To study the dynamics of big bubble (BB) formation in eyes with advanced keratoconus (KC) during deep anterior lamellar keratoplasty (DALK).Methods: A retrospective review of medical records and videos of DALK surgeries performed during the period from January 2013 to December 2019 on keratoconic eyes. Eyes with formed BB, in the presence of a relatively clear stroma, were included. We studied the following parameters the location of BB commencement, duration from the start of the bubble until complete formation, and the pattern of air passage during the formation process.Results: A total of 37 eyes met the inclusion criteria. Type 1 BB was formed in 22 eyes with a mean formation time of 1.9 ± 1.1 seconds and a mean bubble diameter of 7.6 ± 1.1 mm. Type 1 BB started in the center as a small dome expanding centrifugally with preceding localized stromal whitening in 19 eyes and without whitening in three eyes. Type 2 BB was formed in 14 eyes with a mean formation time of 0.3 ± 0.12 seconds and a mean bubble diameter of 7.4 ± 1.8 mm. Type 2 BB started in the center in 13 eyes and the mid periphery in one eye, through either direct access to the plane between Descemet’s membrane and the pre-Descemet’s layer in six eyes, or preceded by a small intrastromal bubble in eight eyes. Mixed bubble was observed in one eye, which started as a small central Type 1 BB followed by the rapid formation of a Type 2 BB.Conclusion: Eyes with KC are associated with central commencements of both Type 1 and Type 2 BB during DALK. Duration of BB formation was significantly faster in Type 2 BB, with most starting as a small intrastromal bubble before air gain access to the plane between DM and stroma.Keywords: DALK, type 2 big bubble, Descemet’s membraneGoweida MBAbuelkheir AEl-Menawy WARMahmoud SDove Medical Pressarticledalktype 2 big bubbledescemet’s membrane.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4305-4310 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	dalk type 2 big bubble descemet’s membrane. Ophthalmology RE1-994
spellingShingle	dalk type 2 big bubble descemet’s membrane. Ophthalmology RE1-994 Goweida MB Abuelkheir A El-Menawy WAR Mahmoud S Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
description	Mohamed Bahgat Goweida,1,2 Amr Abuelkheir,1,2 Wael Abdel Rahman El-Menawy,1,2 Shahira Mahmoud1,2 1Department of Ophthalmology, Alexandria Main, University Hospital, Alexandria, Egypt; 2Faculty of Medicine, Alexandria University, Alexandria, EgyptCorrespondence: Shahira Mahmoud 4th Ghanem Abd El- Reheem Street, Fleming, Alexandria, EgyptTel +201229557131Email Shahira.rashad@alexmed.edu.egPurpose: To study the dynamics of big bubble (BB) formation in eyes with advanced keratoconus (KC) during deep anterior lamellar keratoplasty (DALK).Methods: A retrospective review of medical records and videos of DALK surgeries performed during the period from January 2013 to December 2019 on keratoconic eyes. Eyes with formed BB, in the presence of a relatively clear stroma, were included. We studied the following parameters the location of BB commencement, duration from the start of the bubble until complete formation, and the pattern of air passage during the formation process.Results: A total of 37 eyes met the inclusion criteria. Type 1 BB was formed in 22 eyes with a mean formation time of 1.9 ± 1.1 seconds and a mean bubble diameter of 7.6 ± 1.1 mm. Type 1 BB started in the center as a small dome expanding centrifugally with preceding localized stromal whitening in 19 eyes and without whitening in three eyes. Type 2 BB was formed in 14 eyes with a mean formation time of 0.3 ± 0.12 seconds and a mean bubble diameter of 7.4 ± 1.8 mm. Type 2 BB started in the center in 13 eyes and the mid periphery in one eye, through either direct access to the plane between Descemet’s membrane and the pre-Descemet’s layer in six eyes, or preceded by a small intrastromal bubble in eight eyes. Mixed bubble was observed in one eye, which started as a small central Type 1 BB followed by the rapid formation of a Type 2 BB.Conclusion: Eyes with KC are associated with central commencements of both Type 1 and Type 2 BB during DALK. Duration of BB formation was significantly faster in Type 2 BB, with most starting as a small intrastromal bubble before air gain access to the plane between DM and stroma.Keywords: DALK, type 2 big bubble, Descemet’s membrane
format	article
author	Goweida MB Abuelkheir A El-Menawy WAR Mahmoud S
author_facet	Goweida MB Abuelkheir A El-Menawy WAR Mahmoud S
author_sort	Goweida MB
title	Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
title_short	Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
title_full	Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
title_fullStr	Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
title_full_unstemmed	Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus
title_sort	dynamics of big bubble formation during deep anterior lamellar keratoplasty in eyes with advanced keratoconus
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/1a061993645b4ff495a153e19ea8f9e7
work_keys_str_mv	AT goweidamb dynamicsofbigbubbleformationduringdeepanteriorlamellarkeratoplastyineyeswithadvancedkeratoconus AT abuelkheira dynamicsofbigbubbleformationduringdeepanteriorlamellarkeratoplastyineyeswithadvancedkeratoconus AT elmenawywar dynamicsofbigbubbleformationduringdeepanteriorlamellarkeratoplastyineyeswithadvancedkeratoconus AT mahmouds dynamicsofbigbubbleformationduringdeepanteriorlamellarkeratoplastyineyeswithadvancedkeratoconus
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Dynamics of Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Eyes with Advanced Keratoconus

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