Venzano al.1 have described a technique of Desce-met membrane air-bubble separation. We also use an. _ air-assisted (reverse big bubble)2 technique to prepare Descemet membrane for Descemet membrane endo-thelial keratoplasty. In our method, a corneoscleral button is placed endothelial side up on a Barron donor punch and fixed by grasping the outer scleral edge with a 0.12 forceps. A 27-gauge bevel-up needle attached to a 2 mL syringe filled with air is inserted into the posterior stroma with the entry point located just outside Schwalbe line. The needle is advanced to the central cornea. Air is gently injected to make a big bubble, detaching Descemet membrane from the posterior stroma. Injecting into the endothelial side-up corneoscleral button allows us better visualization and makes the procedure more feasible, less instrument dependent, and less traumatic.
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