[
    {
        "id": "osp-12584",
        "type": "article-journal",
        "title": "Descemet's membrane macroperforation during interface irrigation in big bubble deep anterior lamellar keratoplasty",
        "author": [
            {
                "family": "Ziaei",
                "given": "Mohammed"
            },
            {
                "family": "Ormonde",
                "given": "Susan E"
            }
        ],
        "URL": "https://omanscience.com/en/articles/descemet-s-membrane-macroperforation-during-interface-irrigation-in-big-bubble-deep-anterior-lamellar-keratoplasty",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2017
                ]
            ]
        },
        "container-title": "Oman Journal of Ophthalmology",
        "volume": "10",
        "issue": "3",
        "page": "241-243",
        "DOI": "10.4103/ojo.ojo_66_2016",
        "publisher": "Medknow Publications",
        "ISSN": "0974-620X",
        "abstract": "This report describes the macroperforation of descemet's membrane (DM) during irrigation of the interface following successful removal of stromal tissue in big bubble (BB) deep anterior lamellar keratoplasty (DALK). A 42-year-old woman with keratoconus underwent a BB DALK procedure. After successful formation of Type 2 bubble and removal of stromal tissue, interface irrigation was performed to remove residual viscoelastic. This led to a macroperforation of DM, and the case was converted to penetrating keratoplasty. To the best of our knowledge, this is the first report of such a complication in the literature. Recognition of a 2 bubble formation during pneumodissection should alert the surgeon to a high risk of DM rupture. We advise against the removal of DM from the donor in such cases as an added measure of safety."
    }
]