PMC10220450_01
Significant shadow artifact from the Fogla probe (white arrow) hinders precise determination of dissection depth in the optical cross-section
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F1
With the metallic Fogla probe in place, OCT images demonstrate significant shadow artifacts [Figure 1] preventing an accurate assessment of the depth of the dissection plane.
With an 8-0 nylon suture passed into the stromal tunnel created by the Fogla probe, there is minimal shadow artifact and the depth of the tunnel can be clearly visualized in the mid-stroma (white arrows)
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F2
An 8-0 nylon suture provided the right balance of a small gauge suture with enough rigidity and it was threaded into the pre-dissected stromal tunnel and spectral domain OCT images (Zeiss Rescan 700 operating microscope, Carl Zeiss Meditec, Jena, Germany) revealed that it was located at approximately 50% depth [Figure 2].
With an 8-0 nylon suture passed into a deeper stromal tunnel, optical cross-section reveals that the tunnel is located in the deep stroma (white arrows), nearly adjacent to the Descemet membrane, indicating an appropriately deep plane for pneumatic dissection
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F3
This time, OCT images showed that the stromal tunnel, identified with the 8-0 nylon suture was located in the very deep posterior stroma, nearly abutting the Descemet membrane [Figure 3].
A successful big bubble has been achieved, with pneumatic separation of overlying stroma from Descemet membrane (white asterisks)
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F4
A Fogla cannula was inserted into this tunnel and air insufflation readily produced a big bubble [Figure 4].