Donor cornea preparation in partial big bubble deep anterior lamellar keratoplasty

Abstract

Li Lim,1 Samuel Wen Yan Lim21Corneal and External Eye Disease Service, Singapore National Eye Centre, 2Yong Loo Lin School of Medicine, National University of Singapore, SingaporeBackground: The purpose of this paper is to describe a technique of donor cornea preparation to ensure good graft-host apposition in incomplete big bubble deep anterior lamellar keratoplasty.Methods: Following a partial-thickness trephination, manual dissection and excision of corneal stroma was performed. Anwar's big-bubble technique involving a deep stromal air injection was then initiated. However, the big bubble could not extend to the trephination edge and the peripheral residual corneal stroma could not be removed. Donor cornea preparation involving trimming of the posterior lip of the corneal button was then performed and good graft-host apposition was obtained without graft over-ride.Results: We performed peripheral donor cornea trimming prior to allograft placement in order to ensure good graft-host apposition. Postoperatively, best-corrected visual acuity in both eyes was 6/7.5.Conclusion: Donor cornea preparation involving trimming of the posterior lip of the corneal button is a useful technique in instances where the big bubble does not extend to the trephination edge and ensures good graft-host apposition.Keywords: deep anterior lamellar keratoplasty, incomplete Anwar big bubble deep anterior lamellar keratoplasty, donor cornea preparation