Microbubble technique in failed deep anterior lamellar keratoplasty: 2-year outcomes



To compare the long-term results of big-bubble technique and microbubble techniques to complete stroma dissection after failure of achieving a big-bubble.


A total of 35 eyes with keratoconus underwent lamellar keratoplasty with the big-bubble technique (15 eyes) or the microbubble technique (15 eyes). Conversion to penetrating keratoplasty was performed in 3 eyes of the big-bubble group and in 2 eyes of the microbubble group. Best-corrected visual acuity, corneal thickness, corneal astigmatism, and endothelial cell count were assessed preoperatively and at 12 and 24 months after surgery.


Mean preoperative visual acuity was 0.29 ± 0.18 in the big-bubble group and 0.25 ± 0.15 in the microbubble group. Postoperatively, all patients showed a regular interface between donor and recipient tissue. At 24 months, mean best-corrected visual acuity was 0.84 ± 0.16 in the big-bubble group and 0.68 ± 0.17 in the microbubble group (p = 0.013), and mean central corneal thickness was 530 ± 39 µm in the big-bubble group and 545 ± 30 µm in the microbubble group. Astigmatism was 2.41 ± 1.29 D and 3.59 ± 1.48 D (p = 0.036), respectively, while endothelial cell density was 1,671 ± 371 in the big-bubble group and 1,567 ± 275 in the microbubble group.


The microbubble technique appears to be a valid alternative as it was safe and provided good functional results.

Post author correction


Article Subject: Cornea



Stefano Lippera, Giuseppe Pallotta, Piero Ferroni, Myrta Lippera, Leopoldo Spadea, Carlo Cagini

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.



  •  Eye Unit, “E. Profili” Hospital, Fabriano (Ancona) - Italy
  •  Department of Biotechnology and Medical-Surgical Science, “Sapienza” University of Rome, Latina - Italy
  •  Ophthalmology Section, Department of Surgery and Biomedical Science, S.M. della Misericordia Hospital, University of Perugia, Perugia - Italy

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.