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CASE REPORT
Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 241-243

Descemet's membrane macroperforation during interface irrigation in big bubble deep anterior lamellar keratoplasty


Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

Correspondence Address:
Mohammed Ziaei
Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland
New Zealand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ojo.OJO_66_2016

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This report describes the macroperforation of descemet's membrane (DM) during irrigation of the interface following successful removal of stromal tissue in big bubble (BB) deep anterior lamellar keratoplasty (DALK). A 42-year-old woman with keratoconus underwent a BB DALK procedure. After successful formation of Type 2 bubble and removal of stromal tissue, interface irrigation was performed to remove residual viscoelastic. This led to a macroperforation of DM, and the case was converted to penetrating keratoplasty. To the best of our knowledge, this is the first report of such a complication in the literature. Recognition of a 2 bubble formation during pneumodissection should alert the surgeon to a high risk of DM rupture. We advise against the removal of DM from the donor in such cases as an added measure of safety.


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