A novel method of tunnel creation using intraoperative optical coherence tomography-guided deep anterior lamellar keratoplasty

The big bubble technique has become the technique of choice for performing deep anterior lamellar keratoplasty (DALK) since its inception in 2002. The main challenge with this technique is in achieving a big bubble while preventing inadvertent perforation of the Descemet’s membrane. Although femtosecond lasers have increased the safety, accuracy, and predictability of corneal dissection in DALK, the challenge of achieving a big bubble still exists. To overcome this challenge, Zeimer Z8 Femto LDV has launched a new software module for DALK, which has an added advantage of real-time optical coherence tomography–assisted femtosecond tunnel creation for achieving a big bubble.