Easy Bubble: Pachymetry-assisted Big-Bubble Deep Anterior Lamellar Keratoplasty

We present a simple, effective and reproducible technique for deep anterior lamellar keratoplasty. Using a diamond knife, set at 90% of corneal thickness (90 degrees meridian), at the limbus a radial incision was made and a corneal pocket was created. A specially designed cannula was placed deep into the corneal stroma and air was injected for stromal dissection. The air bubble pushed down Descemet ́s membrane and the endothelium. Partial-thickness trephination of 8 mm was performed. The anterior stroma was removed with Vannas scissors and the donor button was sutured. The main advantage of this technique is the very low learning curve required as well as the evenness of stromal dissection with almost no residual tissue left over Descemet’s membrane. J Emmetropia 2012; 3: 153-156