By Namrata Sharma MD MBBS; Vishal Jhanji MD; Jeewan S Titiyal MD; Rasik B Vajpayee MD
    Cornea/External Disease

    Deep anterior lamellar keratoplasty (DALK) using the big-bubble technique was done bilaterally in Hurler Schie syndrome. Due to sparing of Descemet membrane (DM) and increased chances of glaucoma, DALK is a safer option. 7.5mm trephination was done at a 300¦m depth. A 27-gauge needle was used to inject an air bubble between the DM and the host corneal stroma. After debulking of anterior two-thirds corneal stroma, an opening was created in the stromal tissue. Following air egression from the incision site, viscoelastic was injected in the supernumerary space above the DM. Quadrantic splitting and excision of stromal layers was done. An 0.5mm oversized donor lenticule was secured. At 3 years, BCVA was 20/40 in both eyes. DALK is safe, effective, and plausible in cases of Hurler Schie syndrome.