Identification and Management of a Central Type 2 Big Bubble in Deep Anterior Lamellar Keratoplasty

Author:

Wileman Justin M.1,Price Marianne O.2,Price Francis W.1

Affiliation:

1. Price Vision Group, Indianapolis, IN; and

2. Cornea Research Foundation of America, Indianapolis, IN.

Abstract

Purpose: The purpose of this study was to document a case of central type 2 bubble formation during deep anterior lamellar keratoplasty and discuss its intraoperative management. Methods: A rare case of central type 2 bubble formation with no peripheral extension beyond the trephination mark was documented with operative video and concurrent intraoperative optical coherence tomography imaging. Results: The type 2 bubble was decompressed with a needle intraoperatively, and deep anterior lamellar keratoplasty was successfully performed without perforation of Descemet membrane. Conclusions: Identifying formation of a type 2 bubble during deep anterior lamellar keratoplasty is crucial in avoiding perforation of Descemet membrane. This case shows that the behavior of type 2 bubbles can be different than what has been widely reported. It is hoped that this will aid the surgeon in identifying a type 2 bubble and in properly managing it intraoperatively.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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