purpose: to assess parameters that had a capability of influencing the rate of big bubble formation during deep anterior lamellar keratoplasty (dalk) in keratoconus. methods: a total of 290 consecutive eyes from 257 patients with keratoconus that underwent dalk using the big-bubble technique were enrolled. the influence of patient age and sex, family history of keratoconus, history of contact l...

purpose: to investigate the results of deep lamellar keratoplasty (dlk) by big bubble method with using shifting bubble sign in patients suffering from keratoconus or corneal opacity methods: in this prospective interventional clinical trial, 20 eyes of 18 patients (10 males and 8 females) who underwent dlk by big bubble method using shifting bubble sign were investigated. mean age of cases wer...

purpose: to determine the dissection level during deep lamellar keratoplasty (dalk) using the big-bubble technique by light microscopy (lm) and transmission electron microscopy (tem). methods: descemet’s membrane (dm) and stromal tissue of 4 keratoconic eyes were removed because of inadvertent intraoperative dm perforation during dalk which was converted to penetrating keratoplasty. these speci...

PURPOSE To report 2 cases of delayed spontaneous Descemet membrane (DM) reattachment following big-bubble deep anterior lamellar keratoplasty (DALK). METHODS A 21-year-old man with keratoconus and a 36-year-old woman with corneal macular dystrophy underwent big-bubble DALK. No injury to DM was noted intraoperatively or postoperatively. Postoperatively, the patients developed central DM detach...

PURPOSE To report clinical outcomes of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in patients with keratoconus. DESIGN Prospective noncomparative interventional study. METHODS SETTING Single hospital. PATIENTS Eighty-one unselected consecutive patients with moderate to advanced keratoconus intolerant to contact lenses and with poor spectacle-corrected vis...

purpose: to determine the effect of retained donor descemet membranes (dms) on visual outcomes following deep anterior lamellar keratoplasty (dalk). methods: in this retrospective comparative study, keratoconic eyes undergoing dalk using the big-bubble technique were enrolled. a bared dm was achieved in all cases. a donor cornea without (group 1; 48 eyes) or with (group 2; 22 eyes) dm was sutur...

Numerical simulations of the small bubble-big bubble-liquid three phase heterogeneous flow in a square cross-sectioned bubble column were carried out with the commercial CFD package CFX-4.4 to explore the effect of superficial velocity and inlet dispersed phase fractions on the flow patterns. The approach of Krishna et al. (2000) was adopted in the Euler-Euler framework to numerically simulate ...

Purpose To report the first case of acute angle closure due to a high-pressure Descemet membrane detachment following deep anterior lamellar keratoplasty (DALK) using the "big bubble" technique. Observations A 25-year-old man underwent DALK surgery for keratoconus using the "big bubble" technique in which an air bubble is injected in deep stroma to promote dissection of underlying Descemet me...

Objective. To evaluate the therapeutic effect of big bubble deep anterior lamellar keratoplasty (DALK) in patients with deep fungal keratitis. Methods.Consecutive patients who had DALK for deep fungal keratitis at Shandong Eye Hospital between July 2011 and December 2012 were included. In all patients, the infiltration depth was more than 4/5ths of the corneal thickness. DALK surgery was perfor...

Safe and efficient exposure of Descemet membrane is the key to success in deep anterior lamellar keratoplasty. Although widely used, the big-bubble technique has the drawback of difficulty in maintaining appropriate needle insertion depth in the corneal stroma, resulting in injected air sometimes escaping to the peripheral cornea without separation of Descemet membrane. We describe a variation ...