Successful Big Bubble-Assisted Deep Anterior Lamellar Keratoplasty in a Patient with Intracorneal Ring Segments and Previous Corneal Collagen Cross-Linking for Keratoconus

Background

Patients with keratoconus often have to undergo a number of different treatment methods, depending on the stage and severity of the disease, in order to achieve satisfactory visual acuity [1]. In cases of advanced keratoconus, a deep anterior lamellar keratoplasty (DALK) could be considered for visual rehabilitation [2], but is often limited by the treatments performed in earlier stages, such as cross-linking (CXL) or implantation of intracorneal ring segments (ICRS).

So far, a big bubble-assisted DALK on patients with status after cross-linking and ICRS implantation hasnʼt been reported. In the following case, we intend to highlight that the presence of neither ICRS nor a pretreatment with cross-linking has a negative impact on the surgical outcome. On the contrary, the presence of ICRS facilitates an even better orientation of the air cannula while attempting the big bubble technique.

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