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    By Consuelo Lopez Abad MD; Diana Santander Garcia, MD; David Diaz-Valle MD PhD; Rosalia Mendez Fernandez; Ricardo Cuina Sardina; Pedro Arriola-Villalobos, MD; Maria T Iradier MD PhD; Jose M Benitez del Castillo MD
    Cornea/External Disease

    We present the case of a 65-year-old man with advanced keratoconus in his left eye who underwent Keraring implantation with femtosecond laser. Although reaching a BCVA of 20/50, he had contact lens intolerance. Ten months later, the patient underwent simultaneous removal of ICRS and DALK surgery. The technique presented herein consisted of the creation of a lamellar corneal dissection, explantation of ring segments, and big bubble formation with bearing of the Descemet membrane. The video shows how air creates a supernumerary space between stroma and Descemet membrane and how it egresses when the incision is made. Eight months after, BCVA was 20/40.