Marcon Alexandre S, Rapuano Christopher J, Jones Matthew R, Laibson Peter R, Cohen Elisabeth J
Cornea Service, Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology. 2002 Dec;109(12):2325-30. doi: 10.1016/s0161-6420(02)01288-5.
To analyze the possible causes of Descemet's membrane detachment (DMD) and the treatment and outcome of patients after cataract surgery.
Retrospective noncomparative interventional case series.
Fifteen eyes of 12 patients.
We reviewed clinical data on 15 eyes of 12 patients with nonscrolled DMD after cataract surgery who presented to the Cornea Service at Wills Eye Hospital from 1986 to 2001. Institutional review board/ethics committee approval was obtained.
Visual acuity and reattachment of Descemet's membrane.
Cataract procedures involved nine clear-corneal eyes, four limbal incisions, one trabeculectomy/combined phacoemulsification, and one extracapsular cataract extraction. From 1986 to 1990, we had 1 patient; from 1991 to 1995, no patients; and from 1996 to 2001, 11 patients (including all clear-corneal eyes). Of the 15 eyes, 8 resolved with medical treatment alone, with a mean time to resolution of 9.8 weeks. One patient was lost to follow-up while improving on medical treatment, and another required a penetrating keratoplasty (PK) after medical treatment failed. Five eyes received anterior-chamber SF(6) gas injection. Of these eyes, three DMDs resolved, one underwent repeated injection (not improving after 10 weeks), and another required a PK.
Referrals for DMD seem to be increasing. This may be explained by the increase in clear-corneal cataract procedures. Medical treatment seems to be adequate in many cases and may be appropriate initial therapy. When needed, SF(6) gas injection may also be successful, but not in all cases.
分析白内障手术后Descemet膜脱离（DMD）的可能原因以及患者的治疗方法和预后。
回顾性非对照干预性病例系列研究。
12例患者的15只眼。
我们回顾了1986年至2001年在威尔斯眼科医院角膜科就诊的12例白内障手术后发生非卷曲性DMD患者的15只眼的临床资料。获得了机构审查委员会/伦理委员会的批准。
视力和Descemet膜的复位情况。
白内障手术方式包括9例透明角膜切口、4例角膜缘切口、1例小梁切除术/联合超声乳化术以及1例囊外白内障摘除术。1986年至1990年有1例患者；1991年至1995年无患者；1996年至2001年有11例患者（包括所有透明角膜切口的病例）。15只眼中，8只眼仅通过药物治疗得以恢复，平均恢复时间为9.8周。1例患者在药物治疗病情改善过程中失访，另1例患者药物治疗失败后需要进行穿透性角膜移植术（PK）。5只眼接受了前房注入六氟化硫（SF₆）气体治疗。其中，3只眼的DMD得以恢复，1只眼接受了重复注射（10周后未改善），另1只眼需要进行PK。
DMD的转诊病例似乎在增加。这可能是由于透明角膜白内障手术的增加所致。在许多情况下，药物治疗似乎足够，可能是合适的初始治疗方法。必要时，注入SF₆气体也可能成功，但并非对所有病例都有效。
