PURPOSE: To investigate the pressure required to rupture the posterior lamella obtained during the presumed Descemet membrane-baring big-bubble technique of deep anterior lamellar keratoplasty (DALK). METHODS: DALK using the big-bubble technique was carried out on donor corneoscleral discs mounted on an artificial anterior chamber. Once the anterior lamella was removed, the chamber was connected to a mercury manometer. The pressure inside the chamber was increased until rupture occurred or the manometer reached its measurement limit. RESULTS: The deep lamella ruptured at 252 mm Hg in one cornea, at 270 mm Hg in another, and had not ruptured at 300 mm Hg (upper limit of the manometer) in the remaining 18 donor corneas. CONCLUSIONS: The posterior lamella of big-bubble DALK probably confers significant structural integrity on the globe.
PURPOSE: To investigate the pressure required to rupture the posterior lamella obtained during the presumed Descemet membrane-baring big-bubble technique of deep anterior lamellar keratoplasty (DALK). METHODS: DALK using the big-bubble technique was carried out on donor corneoscleral discs mounted on an artificial anterior chamber. Once the anterior lamella was removed, the chamber was connected to a mercury manometer. The pressure inside the chamber was increased until rupture occurred or the manometer reached its measurement limit. RESULTS: The deep lamella ruptured at 252 mm Hg in one cornea, at 270 mm Hg in another, and had not ruptured at 300 mm Hg (upper limit of the manometer) in the remaining 18 donor corneas. CONCLUSIONS: The posterior lamella of big-bubble DALK probably confers significant structural integrity on the globe.