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Big bubble DALK technique effective for corneal opacities

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Good visual outcomes can be achieved from deep anterior lamellar keratoplasty performed using the big bubble technique on eyes with corneal stromal dystrophies, corneal clouding from mucopolysaccharidoses and stromal scars from infectious keratitis, a small prospective study found.

Rasik B. Vajpayee, MS, FRCSEd, FRANZCO, and colleagues investigated the efficacy of the technique in 10 eyes of eight patients. All eyes had developed stromal pathologies that had spared Descemet's membrane.

In all cases, the big bubble technique for deep anterior lamellar keratoplasty (DALK) successfully separated Descemet's membrane from the corneal stromal tissue. No eyes experienced intra- or postoperative complications, the authors reported.

All patients achieved 20/40 or better best corrected visual acuity at 6 months follow-up, they noted.

"Our study highlights the successful use of the DALK with the big bubble technique," they said. "In addition to eliminating the risk of endothelial rejection, low-quality donor corneal tissue can be used, therefore easing the shortage of good-quality donor tissue prevalent in developing countries."

The study is published in the June issue of American Journal of Ophthalmology.