Didar S Anwar
Hawler Medical Univeristy, Iraq
Didar S. Anwar MD, has completed his fellowship in cornea and refractiver surgery at the Univeristy of Texas Southwestern. He is now the only corneal specialt in Erbil, Iraq. The first eye doctor to start cornea transplant surgery overthere. He is now on faculty in the Ophthalmology department of the Hawler Medical University. He is publised more than 10 peer-reviwed papers.
The purpose of this talk is to describe a new technique for corneal stromal dissection in Deep Anterior Lamellar Keratoplasty (DALK) after a failed big bubble attempt. The technique utilizes blunt lamellar dissection with blunt-tipped corneal miniscissors. Traditionally, a crescent blade is used for this dissection, which can be difficult for surgeons to master and is associated with a high risk of perforation. Other techniques of blunt dissection, such as the Melles technique, cannot proceed after a failed big bubble due to emphesyma in the stroma that prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of Descemet’s membrane created during big bubble attempt. In conclusion, this technique provides DALK surgeons with an easier, more reliable technique that can proceed after failure of a big bubble, thereby significantly increasing the success rate of DALK. A case series study is needed to evaluate the short and long term visual and clinical outcome of this technique.
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