Results of anterior lamellar keratoplasty performed with “big bubble” technique

Introduction
To present the results of deep anterior lamellar keratoplasty (DALK) using “big bubble” technique, performed from 2006 to 2008 in Ophthalmology Department, District Railway Hospital in Katowice.

Material and methods
53 patients (53 eyes) underwent DALK using “big bubble” technique due to keratoconus, corneal dystrophies and postinflammatory corneal opacification with continue Descemet’s membrane and healthy endothelium. Best corrected visual acuity, main astigmatism, central corneal thickness, endothelium cell density, intra- and postoperative complications were assessed.

Results
: Mean follow up 15.4 months ranged from 11 to 24 months. Averaged best corrected visual acuity averaged equaled 0.6 and ranged from 0.1 to 4.0, mean astigmatism 2.6 D, ranged from 1.0 D to 2.6 D. Mean central corneal thickness was 503.4 μm and ranged from 379 μm to 694 μm, mean endothelium cell density before surgery equaled 2895/ mm2 and postoperatively 2398/ mm2. Incomplete Descemet’s membrane detachment was diagnosed in 3 cases, intraoperative microperforations in 5 eyes and conversion to penetrating keratoplasty was needed in 4 patients. Postoperative disc opacity in 3 cases, increase of intraocular preassures in 1 case and early postoperative Descemet’s membrane detachment in 1 eye. Posterior cataract formation in 4 eyes and in 1 case permanent mydriasis (Urrets–Zavalia Syndrome), was observed. There was no graft rejection observed.

Conclusions
Although technically more demanding lamellar keratoplasty, could be considered as an alternative “gold standard” penetrating keratoplasty.