Common-path optical coherence tomography guided vertical pneumodissection for DALK.

We reported a design and evaluation of an optical coherence tomography (OCT) sensor-integrated 27 gauge vertically inserted razor edge cannula (VIREC) for pneumatic dissection of Descemet's membrane (DM) from the stromal layer. The VIREC was inserted vertically at the apex of the cornea to the desired depth near DM. The study was performed using ex vivo bovine corneas (N = 5) and rabbit corneas (N = 5). A clean penumodissection of a stromal layer was successfully performed using VIREC without any stomal blanching on bovine eyes. The "big bubble" was generated in all five tests without perforation. Only micro bubbles were observed on rabbit eyes. The results proved that VIREC can be an effective surgical option for "big bubble" DALK.