Dr.Shahbaaz Mohd
DALK is the preferred way of managing corneal pathology in case where endothelium is normal; it is graded superior to PK as it reduces chance graft rejection, it also have faster recovery than PK with early suture removal. DALK need more expertise as the procedure is more challenging than conventional PK. After Anwar’s big bubble the surgery became relatively easy as bubble separate stroma from DM reducing chance of perforation during manual dissection. Type one bubble does not reach up to the periphery and it’s formed between pre descendent layer and the stroma while type 2 is formed between Descemet’s membrane and the pre descendents so it reach up to the TBM and can leads to the leakage of air in to the AC giving feeling of DM rupture to the operating surgeon. This video shows the leak of air bubble in AC from TBM which can be confirmed after the dissection of stroma from DM by manual dissection.