Novel spatula and dissector for safer deep anterior lamellar keratoplasty

Detalhes bibliográficos
Autor(a) principal: Bonfadini,Gustavo ,2,3
Data de Publicação: 2014
Outros Autores: Kim,Eun Chul, Campos,Mauro 3, Jun,Albert S.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000500279
Resumo: Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK). Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK). After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB) separation of Descemet membrane (DM) from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.
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spelling Novel spatula and dissector for safer deep anterior lamellar keratoplastyDeep anterior lamellar keratoplastyCorneal transplantation/methodsKeratoplastyBonfadini dissectorBonfadini spatula Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK). Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK). After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB) separation of Descemet membrane (DM) from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery. Sociedade Brasileira de Oftalmologia2014-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000500279Revista Brasileira de Oftalmologia v.73 n.5 2014reponame:Revista Brasileira de Oftalmologia (Online)instname:Sociedade Brasileira de Oftalmologia (SBO)instacron:SBO10.5935/0034-7280.20140060info:eu-repo/semantics/openAccessBonfadini,Gustavo ,2,3Kim,Eun ChulCampos,Mauro 3Jun,Albert S.eng2015-02-13T00:00:00Zoai:scielo:S0034-72802014000500279Revistahttps://rbo.emnuvens.com.br/rbo/indexhttps://old.scielo.br/oai/scielo-oai.phpsob@sboportal.org.br||rbo@sboportal.org.br1982-85510034-7280opendoar:2015-02-13T00:00Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)false
dc.title.none.fl_str_mv Novel spatula and dissector for safer deep anterior lamellar keratoplasty
title Novel spatula and dissector for safer deep anterior lamellar keratoplasty
spellingShingle Novel spatula and dissector for safer deep anterior lamellar keratoplasty
Bonfadini,Gustavo ,2,3
Deep anterior lamellar keratoplasty
Corneal transplantation/methods
Keratoplasty
Bonfadini dissector
Bonfadini spatula
title_short Novel spatula and dissector for safer deep anterior lamellar keratoplasty
title_full Novel spatula and dissector for safer deep anterior lamellar keratoplasty
title_fullStr Novel spatula and dissector for safer deep anterior lamellar keratoplasty
title_full_unstemmed Novel spatula and dissector for safer deep anterior lamellar keratoplasty
title_sort Novel spatula and dissector for safer deep anterior lamellar keratoplasty
author Bonfadini,Gustavo ,2,3
author_facet Bonfadini,Gustavo ,2,3
Kim,Eun Chul
Campos,Mauro 3
Jun,Albert S.
author_role author
author2 Kim,Eun Chul
Campos,Mauro 3
Jun,Albert S.
author2_role author
author
author
dc.contributor.author.fl_str_mv Bonfadini,Gustavo ,2,3
Kim,Eun Chul
Campos,Mauro 3
Jun,Albert S.
dc.subject.por.fl_str_mv Deep anterior lamellar keratoplasty
Corneal transplantation/methods
Keratoplasty
Bonfadini dissector
Bonfadini spatula
topic Deep anterior lamellar keratoplasty
Corneal transplantation/methods
Keratoplasty
Bonfadini dissector
Bonfadini spatula
description Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK). Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK). After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB) separation of Descemet membrane (DM) from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.
publishDate 2014
dc.date.none.fl_str_mv 2014-10-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000500279
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000500279
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/0034-7280.20140060
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
dc.source.none.fl_str_mv Revista Brasileira de Oftalmologia v.73 n.5 2014
reponame:Revista Brasileira de Oftalmologia (Online)
instname:Sociedade Brasileira de Oftalmologia (SBO)
instacron:SBO
instname_str Sociedade Brasileira de Oftalmologia (SBO)
instacron_str SBO
institution SBO
reponame_str Revista Brasileira de Oftalmologia (Online)
collection Revista Brasileira de Oftalmologia (Online)
repository.name.fl_str_mv Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)
repository.mail.fl_str_mv sob@sboportal.org.br||rbo@sboportal.org.br
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