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Deep lamellar keratoplasty with air dissection useful for keratoconus

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LISBON, Portugal – Performing deep lamellar keratoplasty with air bubble dissection allows the surgeon to treat keratoconus while preserving the patient’s endothelium, Mohammed Alaa El-Danasoury, MD, said here at the European Society of Cataract and Refractive Surgeons meeting.

“Endothelial rejection is the main disadvantage of penetrating keratoplasty,” he said.

To test the efficacy of the technique, Dr. El-Danasoury treated 50 patients with keratoconus with deep lamellar keratoplasty with air bubble injection in the pre-Descemet’s plane.

“This is a planned exposure of Descemet’s membrane,” he said.

At 1 year postoperative, of 46 eyes examined, 80% reached 20/40 or better best corrected visual acuity. Complications included fixed dilated pupil, irregular astigmatism and temporary Descemet’s membrane detachment, but no endothelial rejection occurred.

“Overall, inserting the air bubble makes deep lamellar keratoplasty safer in higher risk patients, and there’s an easy conversion to penetrating keratoplasty if you need it,” he said. “The disadvantage is it’s a time consuming procedure.”