Kymionis George D, Suh Leejee H, Dubovy Sander R, Yoo Sonia H
Department of Ophthalmology, Vardinoyannion Eye Institute of Crete, Crete, Greece.
J Cataract Refract Surg. 2007 Jul;33(7):1322-4. doi: 10.1016/j.jcrs.2007.03.029.
We present a patient with residual Descemet's membrane diagnosed by anterior segment optical coherence tomography (AS-OCT) after Descemet's stripping endothelial keratoplasty (DSEK). Postoperatively, persistent partial corneal edema and interface fluid without dislocation of the donor button were observed. No improvement of interface fluid was found during the follow-up period. A primary donor graft failure was diagnosed within 4 months, and the patient was regrafted with penetrating keratoplasty. Pathology examination of the specimen revealed the presence of residual Descemet's membrane in the recipient corneal button, confirmed using AS-OCT imaging. This case report demonstrates that inadequate Descemet's stripping in the recipient button could be a potential cause of DSEK failure; AS-OCT is a useful and noninvasive instrument for diagnosing and monitoring this post-DSEK complication.
我们报告了一名在进行Descemet膜剥脱内皮角膜移植术（DSEK）后经眼前节光学相干断层扫描（AS-OCT）诊断为存在残留Descemet膜的患者。术后，观察到持续性部分角膜水肿和界面积液，且植片未脱位。在随访期间，界面积液未见改善。在4个月内诊断为原发性供体植片失败，该患者接受了穿透性角膜移植术再次移植。标本的病理学检查显示在受体角膜植片中存在残留的Descemet膜，这通过AS-OCT成像得以证实。本病例报告表明，受体植片中Descemet膜剥脱不充分可能是DSEK失败的一个潜在原因；AS-OCT是诊断和监测这种DSEK后并发症的一种有用且无创的工具。
