AIR-VISCO BUBBLE EXCHANGE DALK TECHNIQUE

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AIR-VISCO BUBBLE EXCHANGE DALK TECHNIQUE
S. Fyodorov Eye Microsurgery State
Institution Moscow, Russia

• Prof. Boris Malyugin
• Prof. Zinaida Moroz
• Andrey Golovin, MD
• Ivan Drozdov, MD
• Denis Merzlov, MD

Financial Disclosure Nothing to disclose in
relation to the topic of this presentation
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DALK ADVANTAGES

• Maintenance of globe integrity
• Reduction of graft rejection possibility
• Decrease of quantity and duration of
  postoperative steroid therapy
• Possibility of using the donor material with
  compromised endothelial layer
• Reduction of complications (expulsive
  hemorrhage, iris and lens damage, intraocular
  infection)
• The recipients endothelium is reserved and the
  endothelial cell count remains relatively stable
  following the procedure

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LAMELLAR DISSECTION TECHNIQUES
AIR INJECTION Archila (1984) Price (1989) Chan
(1992) Morris (1998) Anwar Teichmann (2002)
HYDRODELAMINATION Sugita (1994) Krumeich
(2009) VISCOELASTIC Manche et al. (1999)
Melles et al. (2000) Pakrou et al.
(2006) Fournie P. et al. (2007)
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DESCEMETS MEMBRANE PERFORATION RATES
0 Manche et al. (1999) 0-15
Watson et al. (2004) 7.6 Shimazaki et al.
(2002) 8.7 Pakrou et al. (2006) 9
Anwar Teichmann (2002) 11.1 Caprossi et
al. (2004) 16.1 Wylegala et al. (2004) 20
Coombes et al. (2000)
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AIR-VISCO BUBBLE EXCHANGE DALK TECHNIQUE
PARTIAL THICKNESS TREPHINATION
AIR INJECTION
AIR BUBBLE FORMATION
AIR-VISCO BUBBLE EXCHANGE
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AIR-VISCO BUBBLE EXCHANGE DALK TECHNIQUE
LAMELLAR TRANSPLANTATION 1
DM AFTER STROMAL RESECTION
LAMELLAR TRANSPLANTATION 1
SUTURING
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HISTOLOGY OF SURGICAL EMPHYSEMA
EXPERIMENTAL RESEARCH
6 cadaver eyes
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HISTOLOGY OF DESCEMETS MEMBRANE DETACHMENT
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STUDY GROUP
17 Eyes (15 patients) 9 Males, 6 Females D-s
Keratoconus Age 26.7/-4.2 years
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COMPLICATIONS
Descemets membrane detachment 1 case
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OPTICAL COHERENCE TOMOGRAPHY
FUNCTIONAL RESULTS
1st day post op
6 months post op88 of eyes achieved BCVA 0.5
(20/40) or better
1st month post op
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COINCLUSIONS

• The use of air-visco bubble (AVB) exchange DALK
  technique is easy, safe and produces low rate of
  complications as well as the favorable visual
  results.