Objectives & Purpose: Demonstrate a Deep Anterior Lamellar Keratoplasty (DALK) using small-bubble and big-bubble air injection techniques. 
Methods: The cornea was marked with a radial keratomoy marker and an 80% percent partial thickness trephination performed. A small-bubble was injected into the anterior chamber. A Fogla pointed dissectorwas used to enter the deep corneal stroma. Air was injected using a 27-gauge Fogla canula forming a Type 1 big-bubble. During air injection, the small-bubbles move
to the periphery confirming big-bubble formation. The anterior stroma was debulked and a brave slash performed releasing the big-bubble without violating Descemet's membrane. The posterior stromal leaflets were excised and the donor cornea was prepared and sutured in place. 
Results: Relative paucity of stromal emphysema and use of combined small-bubble and big-bubble technique facilitate visualization of critical DALK surgical steps. 
Conclusion: This video provides an educational resource clearly illustrating the surgical principles of a big-bubble DALK.

Deep anterior lamellar keratoplasty (DALK) using small and big-bubble techniques

[Poster Abstract Booklet](https://drive.google.com/file/d/1AGitRGyG9W0FiZ2Xjz6RNO2h7C0XglOL/view)

[Surgical Video Abstract Booklet](https://drive.google.com/file/d/1B-IkojrZhXk4AgXzsEQyuE_FwPG1Lvpe/view?usp=sharing)

[To claim Section 2 credits for ePoster review complete this Poster Transcript](https://drive.google.com/open?id=1dSAjpIIqFqD4SUbpcc6-PzX65ZPFhA7O)