Pachy-Bubble Technique for Deep Anterior Lamellar Keratoplasty скачать в хорошем качестве

Pachy-Bubble Technique for Deep Anterior Lamellar Keratoplasty

Deep anterior lamellar keratoplasty with Descemet membrane exposure is the gold standard technique for stromal pathologies including keratoconus. Current techniques, including the big-bubble, have facilitated Descemet exposure, however, they are technically difficult, with a long learning curve, presenting significant challenges for the corneal surgeon. In the Pachy-Bubble technique, after superficial trephination, pachymetry is performed 0.8 mm internally from the trephination groove in the 11 to 1 o'clock position. In this area, a 2 mm incision is created, parallel to the groove, with a micrometer controlled diamond knife calibrated to 90% depth. This incision allows exposure of the deep stroma and the insertion of a cannula for intraestromal air injection. This technique represents a safe, effective and reproducible way to inject air in the deep stroma, facilitating the separation of the Descemet membrane from the stroma and decreasing the risk of perforation.