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Double Bubble Technique For Deep Anterior Lamellar Keratoplasty : Results In 53 Cases

Double Bubble Technique For Deep Anterior Lamellar Keratoplasty : Results In 53 Cases. Sagar Kharosekar MS Ajay K MS, Chetan A MS Suchi Smita MS, Sri Ganesh MS. The authors have no financial interest. We have no financial interest . Purpose To present our experience with

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Double Bubble Technique For Deep Anterior Lamellar Keratoplasty : Results In 53 Cases

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  1. Double Bubble Technique ForDeep Anterior Lamellar Keratoplasty: Results In 53 Cases SagarKharosekar MS Ajay K MS, Chetan A MS SuchiSmita MS, Sri Ganesh MS The authors have no financial interest

  2. We have no financial interest • Purpose To present our experience with double bubble technique of deep lamellar keratoplasty (DALK) for various conditions. 

  3. Methods • Retrospective analysis of refractive outcome of 53 DALK cases • Comparison of Pre and post SR (suture removal) BCVA • Incidence of DM detachment UrettsZavaliaSyndrome Rejection Infection IOP rise Graft dehiscence

  4. Methods • 46 keratoconus 13 with post hydrops scars • 1 post LASIK ectasia • 3 central scars sec to interstitial keratitis • 2 PMCD • 1 severe GDLD • Minimum follow up : 1 yr

  5. Results • Preop BCVA : 4.47/60 (CFCF - 6/24) • DALK done in 48 (90.57%) eyes • 5 converted to PK • IntraopDM microperforationsin 5 eyes, but DALK completed successfully • Of these, 4 eyes required intracameralC3F8 2 with central perforations took 15 and 19 wks respectively for graft edema to recover Both doing well ( BCVA 6/12, N8 & 6/18+, N6 respectively)

  6. Results • PostopUrettsZavalia Syndrome : 12 eyes None recovered • Raised IOP: 2 eyes, managed medically • Graft infection: 4 eyes, All bacterial, 3 GPC, 1 GNB One in previous HSV scar All recovered

  7. Results • 3 eyes required repeat keratoplasty One each for Graft infection (PK) (BCVA 6/12,N6P) Graft dehiscence (Repeat DLK)(6/24,N8) Post suture removal (SR) DM detachment (PK)(6/9,N6) • All doing well

  8. Results • SR completed by 20.1 wks(3-52 wks) • Post SR final average BCVA • 44 eyes: 6/15 (CF 0.5m - 6/6) • 22 eyes: ≥ 6/12 • Cylinder: Average: - 1.43 (0 to – 2.75 D) • No episodes of rejection

  9. Conclusion • Double bubble method ( air in AC & big bubble) worked well in our cases • Visual outcome was good • Urrets Zavalia syndrome was more frequent in our series, probably due to air in AC • Cases of post SR DM detachment & graft dehiscence warrant more precaution during SR.

  10. Thank you

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