深前板层角膜移植术后Descemet膜脱离的自发消退
Spontaneous resolution of descemet membrane detachment after deep anterior lamellar keratoplasty.
作者信息
Tu Kyaw Lin, Ibrahim Mohtar, Kaye Stephen B
机构信息
St. Paul's Eye Unit, Royal Liverpool University Hospital, United Kingdom.
出版信息
Cornea. 2006 Jan;25(1):104-6. doi: 10.1097/01.ico.0000167882.86137.fb.
PURPOSE
To describe a patient whose Descemet membrane detachment following deep lamellar keratoplasty failed to respond to 2 attempts at gas tamponade but later resolved spontaneously.
METHODS
A 77-year-old woman with bilateral anterior corneal stromal scarring underwent a right deep lamellar keratoplasty with the Melles technique. Postoperatively, she developed an inferior Descemet membrane detachment, presumably due to a peripheral inferior microperforation. Two attempts at gas tamponade with sulfur hexafluoride (SF6) and 12% perfluropropane (C3F8) were made.
RESULTS
Gas tamponade was unsuccessful. Five months after deep lamellar keratoplasty, the detachment resolved spontaneously. One year after deep lamellar keratoplasty, the donor cornea was clear, and best corrected visual acuity in the right eye was 20/40 with -2.75/+2.50 x 55.
CONCLUSIONS
Descemet membrane detachment after deep anterior lamellar keratoplasty can resolve spontaneously, even after failed attempts at gas tamponade. Those due to peripheral inferior perforations may be less likely to respond to tamponade than central or superior perforations.
目的
描述一名患者，其在深板层角膜移植术后发生的Descemet膜脱离，在两次气体填塞尝试均无效后，最终自发消退。
方法
一名77岁双侧角膜前基质瘢痕化女性接受了采用Melles技术的右眼深板层角膜移植术。术后，她发生了下方Descemet膜脱离，推测是由于周边下方微小穿孔所致。尝试了两次使用六氟化硫（SF6）和12%全氟丙烷（C3F8）进行气体填塞。
结果
气体填塞未成功。深板层角膜移植术后五个月，脱离自发消退。深板层角膜移植术后一年，供体角膜透明，右眼最佳矫正视力为20/40，散光度数为-2.75/+2.50×55。
结论
深前板层角膜移植术后的Descemet膜脱离即使在气体填塞尝试失败后也可自发消退。因周边下方穿孔导致的脱离可能比中央或上方穿孔导致的脱离对填塞的反应性更低。
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