Big-bubble technique to bare Descemet's membrane in anterior lamellar keratoplasty

J Cataract Refract Surg. 2002 Mar;28(3):398-403. doi: 10.1016/s0886-3350(01)01181-6.


We describe a lamellar keratoplasty technique to bare Descemet's membrane in which air is injected to detach the central Descemet's. After a partial-thickness corneal trephination is performed, a disposable needle is inserted, deeply and bevel down, into the paracentral corneal stroma and air is injected. In most cases, this forms a large air bubble between Descemet's membrane and the corneal stroma. After anterior lamellar keratectomy is performed, a small opening is made in the air bubble and the remaining stromal layers are lifted with an iris spatula, severed with a blade, and excised with scissors. This technique is faster, safer, and easier to perform than previous methods.

MeSH terms

  • Air*
  • Corneal Stroma / surgery
  • Corneal Transplantation / methods*
  • Descemet Membrane / surgery*
  • Humans
  • Keratoconus / surgery*