The recent publication by Lucchino et al reports on preoperative predictive factors for big bubble (BB) formation during deep anterior lamellar keratoplasty (DALK) in keratoconus eyes.1 In a total of 140 eyes of 140 patients, the authors observed successful pneumatic dissection in 98 eyes (70.0%), with 94 type 1 BB (67.1%) and 4 type 2 BB (2.9%). The study provides topographic evidence for a higher BB success rate among earlier stages of keratoconus, as characterised by lower K-max, lower K-mean, higher corneal thickness at the thinnest point and lower difference in peripheral-minimal corneal thickness. Moreover, the anterior segment-optical coherence tomography (AS-OCT) classification2 was found to be the only factor that predicted BB formation, with mild to moderate keratoconus eyes, particularly those with no posterior stromal scars, demonstrating a greater likelihood of undergoing successful BB creation. DALK is widely accepted as a preferred type of keratoplasty for anterior stromal pathologies such as keratoconus or scars.3 4 While achieving similar visual recovery …

中文翻译：

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深前板层角膜移植术中的大气泡形成在早期圆锥角膜眼中可能更成功


Lucchino 等人最近发表的文章报告了圆锥角膜眼深前板层角膜移植术 （DALK） 中大气泡 （BB） 形成的术前预测因素。在 140 名患者的总共 140 只眼中，作者观察到 98 只眼 （70.0%） 成功进行气学解剖，其中 94 只 1 型 BB （67.1%） 和 4 只 2 型 BB （2.9%）。该研究提供了地形学证据，证明圆锥角膜早期阶段的 BB 成功率较高，其特征是 K-max 较低、K-mean 较低、最薄点的角膜厚度较高以及周边最小角膜厚度的差异较小。此外，发现眼前节光学相干断层扫描 （AS-OCT） 分类 2 是预测 BB 形成的唯一因素，轻度至中度圆锥角膜眼，尤其是那些没有后基质疤痕的眼，表明成功创建 BB 的可能性更大。DALK 被广泛认为是前基质病变（如圆锥角膜或疤痕）的首选角膜移植术类型3 4 虽然实现了类似的视觉恢复......