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Femtosecond facilitates 'big bubble'

Use of the femtosecond laser holds promise for standardizing the 'big bubble' technique and expanding the use of deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty in eligible patients, according to Luca Buzzonetti, MD.

Dr. Buzzonetti, chief, Department of Ophthalmology, Bambino Gesù Hospital, Rome, described his new "IntraBubble" technique in which he uses a proprietary femtosecond laser (IntraLase, Abbott Medical Optics) to create an intrastromal channel that is used as a pathway for the insertion of the air injection cannula.

Thanks to the accuracy of the femtosecond laser, he said, the channel terminates at a predictable depth that optimizes the plane for air injection while minimizing the risk of perforating Descemet's membrane and making the insertion of a smooth, flat, 27-gauge cannula easier and safer.

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