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Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study.

Publication ,  Journal Article
Bhullar, PK; Carrasco-Zevallos, OM; Dandridge, A; Pasricha, ND; Keller, B; Shen, L; Izatt, JA; Toth, CA; Kuo, AN
Published in: Asia Pac J Ophthalmol (Phila)
2017

PURPOSE: To investigate the relationship between intraocular pressure (IOP) and big bubble (BB) formation in a model of deep anterior lamellar keratoplasty (DALK). DESIGN: Ex-vivo. METHODS: Corneoscleral buttons from human donors were loaded onto an artificial anterior chamber connected to a column of balanced salt solution. A surgeon-in-training learned to perform DALK via the BB technique using swept-source microscope-integrated optical coherence tomography (SS-MIOCT) with heads-up display (HUD). DALK procedures were performed at 6 different IOPs (5, 10, 15, 20, 30, or 40 mm Hg; n = 6 per group) in a randomized fashion, with the surgeon-in-training masked to the pressure and guided by SS-MIOCT with HUD. For a subset of corneas within each pressure group, DALK was performed on matching donor tissue at a control IOP. BB diameter was recorded, and a diameter exceeding the trephine diameter was considered optimal. RESULTS: Wilcoxon rank sum test showed a difference in BB diameter among the different pressure groups (mean ± SD of 7.75 ± 1.60, 8.33 ± 1.99, 10.9 ± 0.92, 9.08 ± 1.07, 6.67 ± 3.33, and 3.42 ± 3.77 mm in the 5, 10, 15, 20, 30, and 40 mm Hg groups, respectively; P = 0.0014). Per Tukey test, this difference was attributable to comparisons between the 40 mm Hg group and the 5, 10, 15, or 20 mm Hg groups (P = 0.04, 0.02, 0.0001, 0.004, respectively). CONCLUSIONS: In this ex-vivo model of DALK, the BB technique guided by SS-MIOCT with HUD yielded bubbles of optimal diameters only at physiologic pressures (10‒20 mm Hg). Extremely high IOP (40 mm Hg) resulted in BBs of significantly smaller diameter than BBs obtained at physiologic and low (5 mm Hg) IOPs.

Duke Scholars

Published In

Asia Pac J Ophthalmol (Phila)

DOI

EISSN

2162-0989

Publication Date

2017

Volume

6

Issue

5

Start / End Page

412 / 417

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Tissue and Organ Harvesting
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Female
  • Dissection
  • Descemet Membrane
  • Corneal Transplantation
 

Citation

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Chicago
ICMJE
MLA
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Bhullar, P. K., Carrasco-Zevallos, O. M., Dandridge, A., Pasricha, N. D., Keller, B., Shen, L., … Kuo, A. N. (2017). Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study. Asia Pac J Ophthalmol (Phila), 6(5), 412–417. https://doi.org/10.22608/APO.2017265
Bhullar, Paramjit K., Oscar M. Carrasco-Zevallos, Alexandria Dandridge, Neel D. Pasricha, Brenton Keller, Liangbo Shen, Joseph A. Izatt, Cynthia A. Toth, and Anthony N. Kuo. “Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study.Asia Pac J Ophthalmol (Phila) 6, no. 5 (2017): 412–17. https://doi.org/10.22608/APO.2017265.
Bhullar PK, Carrasco-Zevallos OM, Dandridge A, Pasricha ND, Keller B, Shen L, et al. Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study. Asia Pac J Ophthalmol (Phila). 2017;6(5):412–7.
Bhullar, Paramjit K., et al. “Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study.Asia Pac J Ophthalmol (Phila), vol. 6, no. 5, 2017, pp. 412–17. Pubmed, doi:10.22608/APO.2017265.
Bhullar PK, Carrasco-Zevallos OM, Dandridge A, Pasricha ND, Keller B, Shen L, Izatt JA, Toth CA, Kuo AN. Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study. Asia Pac J Ophthalmol (Phila). 2017;6(5):412–417.

Published In

Asia Pac J Ophthalmol (Phila)

DOI

EISSN

2162-0989

Publication Date

2017

Volume

6

Issue

5

Start / End Page

412 / 417

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Tissue and Organ Harvesting
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Female
  • Dissection
  • Descemet Membrane
  • Corneal Transplantation