DR. ASHIS MAJUMDAR

, Dr. JAYANTA DUTTA

Abstract

Deep anterior lamellar keratoplasty (DALK) is considered the procedure of choice in patients with corneal pathology not involving the endothelium, including keratoconus, stromal dystrophies, and scars and limbal dermoid for cosmetic purpose. Several modifications of DALK have been described for lamellar dissection and removal of the corneal stroma with the Anwar big-bubble (ΒΒ) technique being the most popular. DALK with manual lamellar dissection has been reported to be the preferable surgical technique in cases of corneal stromal scars and big limbal dermoids. Also, in some cases where Big bubble technique fails, where Descemet membrane tear occurs the only alternate is to shift the Operating procedure to penetrating keratoplasty. Herein, I describe a modified technique of DALK assisted by a diamond ophthalmic burr (DOB) polishing of descemet layer where manual dissection is done or the big bubble technique is failed.