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Mark C. Vital, MD
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Anterior lamellar keratoplasty has advantages over PKP but has had limited adoption due to difficulties with dissection and interface haze. The Big Bubble method addresses these issues but can be frustrating due to a high perforation rate even in experienced hands.
Mark C. Vital, MD; Marcel Belloso, MD; James Coffelt; Margaret Tellegen; and Margaret Tellegen; present an alternative technique that is fast, provides clear grafts and good vision with minimal risk of perforation or conversion to PKP.
Posted: 7/07/2016
Mark C. Vital, MD
Anterior lamellar keratoplasty has advantages over PKP but has had limited adoption due to difficulties with dissection and interface haze. The Big Bubble method addresses these issues but can be frustrating due to a high perforation rate even in experienced hands.
Mark C. Vital, MD; Marcel Belloso, MD; James Coffelt; Margaret Tellegen; and Margaret Tellegen; present an alternative technique that is fast, provides clear grafts and good vision with minimal risk of perforation or conversion to PKP.
Posted: 7/07/2016
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Luis Daniel Holfuin
9 years ago
Nice technique. If you start a dissection at 12 o'clock, with a blunt spatula, just beneath the trephination wound, following the wound, 360 degrees, you will notice that every full turn, you go deeper until you reach de predescemet space. Then, the rip is incredibly easy with incredible results. I go with this technique every time my big bubble fails. I think the best tip to make the big bubble happen is to do intraoperative pachymetry and go as deep as 80% with the initial trephination, then dissect with the cannula to inject the air. Thanks for the video, keep creating new techniques.