Big bubble size can be safely increased

Undersized big-bubbles for DALK can safely be increased using blunt dissection for white-margin bubbles and ophthalmic viscosurgical device injection for clear-margin bubbles.

The investigation, headed by Dr H.D. McKee, Manchester Royal Eye Hospital, Manchester, UK, included DALK cases where air injection ruptured the posterior lamella and caused undersized big-bubbles.

In the case of white-margin bubbles that extend to the trephination margin, the bubble can be collapsed and the margins are extended by blunt dissection. However, with undersized clear-margin bubbles a gentle injection of cohesive ophthalmic viscosurgical device is administered into the bubble cavity to increase size.

Both techniques were considered safe for extending big-bubbles beyond the trephination margin for both white and clear-margin bubbles.

The abstract can be viewed in The Journal of Cornea and External Disease.