Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty

Didar Sanwar, Matthew M. Kruger, Venkateswara Mootha

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a “big bubble” detachment of Descemet’s membrane (DM) with deep intrastromal pneumatic injection.

Methods: The technique utilizes blunt lamellar dissection with blunt-tipped corneal mini scissors as an alternative to a crescent blade, which can be difficult for surgeons to master and is associated with a high risk of perforation.

Results: Other techniques of blunt dissection, such as the Melles technique, cannot be utilized after failure to achieve a big bubble, as emphysema in the stroma prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of DM created by the pneumatic injection.

Conclusion: This technique provides deep anterior lamellar keratoplasty surgeons with a simple, alternative method of baring DM or achieving a pre-DM plane with minimal residual stroma, after failure to achieve a big bubble.

Original languageEnglish (US)
Pages (from-to)1849-1854
Number of pages6
JournalClinical Ophthalmology
StatePublished - Sep 15 2014


  • Big bubble
  • Blunt
  • DALK
  • Dissection
  • Scissors

ASJC Scopus subject areas

  • Ophthalmology


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