Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty
Didar S Anwar, Matthew M Kruger, V Vinod Mootha Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA Objective: We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a &ldquo...
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Dove Medical Press
2014
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oai:doaj.org-article:b35ea4e2aac84a7ba1880cd6feffaeb32021-12-02T02:37:46ZBlunt scissors stromal dissection technique for deep anterior lamellar keratoplasty1177-5483https://doaj.org/article/b35ea4e2aac84a7ba1880cd6feffaeb32014-09-01T00:00:00Zhttp://www.dovepress.com/blunt-scissors-stromal-dissection-technique-fornbspdeep-anterior-lamel-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Didar S Anwar, Matthew M Kruger, V Vinod Mootha Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA Objective: We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a “big bubble” detachment of Descemet’s membrane (DM) with deep intrastromal pneumatic injection. Methods: The technique utilizes blunt lamellar dissection with blunt-tipped corneal mini scissors as an alternative to a crescent blade, which can be difficult for surgeons to master and is associated with a high risk of perforation. Results: Other techniques of blunt dissection, such as the Melles technique, cannot be utilized after failure to achieve a big bubble, as emphysema in the stroma prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of DM created by the pneumatic injection. Conclusion: This technique provides deep anterior lamellar keratoplasty surgeons with a simple, alternative method of baring DM or achieving a pre-DM plane with minimal residual stroma, after failure to achieve a big bubble. Keywords: scissors, blunt, dissection, big bubble, DALKAnwar DSKruger MMMootha VVDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1849-1854 (2014) |
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DOAJ |
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DOAJ |
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EN |
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Ophthalmology RE1-994 |
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Ophthalmology RE1-994 Anwar DS Kruger MM Mootha VV Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| description |
Didar S Anwar, Matthew M Kruger, V Vinod Mootha Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA Objective: We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a “big bubble” detachment of Descemet’s membrane (DM) with deep intrastromal pneumatic injection. Methods: The technique utilizes blunt lamellar dissection with blunt-tipped corneal mini scissors as an alternative to a crescent blade, which can be difficult for surgeons to master and is associated with a high risk of perforation. Results: Other techniques of blunt dissection, such as the Melles technique, cannot be utilized after failure to achieve a big bubble, as emphysema in the stroma prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of DM created by the pneumatic injection. Conclusion: This technique provides deep anterior lamellar keratoplasty surgeons with a simple, alternative method of baring DM or achieving a pre-DM plane with minimal residual stroma, after failure to achieve a big bubble. Keywords: scissors, blunt, dissection, big bubble, DALK |
| format |
article |
| author |
Anwar DS Kruger MM Mootha VV |
| author_facet |
Anwar DS Kruger MM Mootha VV |
| author_sort |
Anwar DS |
| title |
Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| title_short |
Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| title_full |
Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| title_fullStr |
Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| title_full_unstemmed |
Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| title_sort |
blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty |
| publisher |
Dove Medical Press |
| publishDate |
2014 |
| url |
https://doaj.org/article/b35ea4e2aac84a7ba1880cd6feffaeb3 |
| work_keys_str_mv |
AT anwards bluntscissorsstromaldissectiontechniquefornbspdeepanteriorlamellarkeratoplasty AT krugermm bluntscissorsstromaldissectiontechniquefornbspdeepanteriorlamellarkeratoplasty AT moothavv bluntscissorsstromaldissectiontechniquefornbspdeepanteriorlamellarkeratoplasty |
| _version_ |
1718402312717729792 |