Novel spatula and dissector for safer deep anterior lamellar keratoplasty
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , |
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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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 |
_version_ |
1752122336997277696 |