DALK Big Bubble Technique modified _ Dirisamer скачать в хорошем качестве

DALK Big Bubble Technique modified _ Dirisamer

In this video we combine some very useful tricks and techniques to optimize the achievement of a big bubble in DALK. First we trephine 2/3 of stromal thickness, as described before, but then we use air in the anterior chamber to facilitate a nice air reflex in order to obtain the proper depth of the needle. This maneuver was first described by Gerrit Melles. He used this technique for safe lamellar dissection in manual DALK. If the stromal tunnel is safely created with the needle we switch to a blunt cannula as the Tan or Fogla Cannula to introduce the Cannula even more to the corneal center and close to Descemet's Membrane in a super safe way. Next step is the injection of the air to create the big bubble. Then removal of the stromal 'cap', small amount of viscoelastic on top prior to the 'brave slash'. Filling the pocket with viscoelastic, cut the residual stromal tissue into 4 quadrants and remove it. Suture the graft, Finish! Thanks to Gerrit Melles, Sadeer Hanush, Rajesh Fogla, and all the other outstanding cornea-collaegues!