Fixed Dilated Pupilla as a Common Complication of Deep Anterior Lamellar Keratoplasty Complicated with Descemet Membrane Perforation

2013 ◽  
Vol 23 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Kansu Tahir Bozkurt ◽  
Banu Torun Acar ◽  
Suphi Acar
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Common Complication ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
Membrane Perforation

scholarly journals ‘Double Bubble’ Technique for Successful Reattachment of Total Descemet Membrane Detachment after Deep Anterior Lamellar Keratoplasty

2018 ◽  
Vol 10 (2) ◽  
pp. 180-183 ◽  
Author(s):  
Jeewan S. Titiyal ◽  
Manpreet Kaur ◽  
Sana Tinwala ◽  
Ruchita Falera
Keyword(s):  
Anterior Chamber ◽  
Air Injection ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Air Bubbles ◽  
Double Bubble ◽  
Air Bubble ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
Descemet Membrane Detachment

Background: A double anterior chamber may be observed after deep anterior lamellar keratoplasty (DALK) and the management may be difficult especially in cases with a total descemet membrane detachment (DMD). Case Observations: We describe a novel “reverse double bubble” surgical technique for safe and effective reattachment of  total DMD following DALK. Total DMD with air bubble in the interface was noted on the first postoperative day following DALK for healed keratitis. Intracameral air was injected via a 30-gauge needle inserted through a partial thickness MVR entry made at the posterior limbus, without disturbing the interface air-bubble. During this maneuver, the interface bubble did not change in size and moved towards the centre. The two distinct air bubbles, one in interface and other in anterior chamber indicated that air injection was in the anterior chamber, as per the reverse double bubble technique. The interface air bubble was removed by gently milking with an iris repositor towards the end of surgery. Thus, successful reattachment of DM was achieved despite difficult assessment of the plane of injection with the DM lying fl at on the surface of the iris. Conclusion: The reverse double bubble technique aids in the safe and successful reattachment of total DMD following intraocular surgeries.

scholarly journals Late Detachment after DALK in a Patient with Descemet Membrane Microperforation

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000010
Author(s):  
Marilia Lordello Passos ◽  
Vinicius Coral Ghanem ◽  
André Luís Piccinini ◽  
Ramon Coral Ghanem
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
History Of

We report a case of late detachment in a patient with Descemet membrane (DM) microperforation following a deep anterior lamellar keratoplasty (DALK). Late detachment of the DM in this case occurred 5 months after DALK because of the flattening pressure during the retinal exam with scleral depression. In patients with a history of microperforation during DALK, we suggest that the retinologist and patient avoid rubbing or applying pressure over the eye to minimize the risk of late detachment of the DM.

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