Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Cornea. 2010 Dec;29(12):1448-51. doi: 10.1097/ICO.0b013e3181e2ef9c.
To describe a surgical technique of deep anterior lamellar keratoplasty (DALK) to treat patients with descemetocele.
Twelve eyes of 12 patients with central or paracentral descemetocele after resolved microbial keratitis underwent viscoelastic-assisted DALK. The mean follow-up of the cases was 19.91 ± 15.80 months (range: 6-48 months).
In all the eyes, a successful DALK could be performed without any intraoperative complications. At the last follow-up visit, all but 1 eye showed significant improvement in visual acuity compared with preoperative visual acuity. The postoperative best-corrected visual acuity did not improve in 1 patient because of glaucomatous optic atrophy, which was present preoperatively. Eight eyes had best-corrected visual acuity of ≥ 20/80, and all but 2 patients had clear grafts at the final follow-up. None of the patients had any evidence of graft infection.
Viscoelastic-assisted DALK is a useful therapeutic option in selected cases of descemetocele after resolved microbial keratitis.
描述一种用于治疗单纯疱疹性角膜炎后角膜水疱的深层前板层角膜移植术（DALK）的手术技术。
12 例（12 只眼）单纯疱疹性角膜炎后中央或旁中央角膜水疱患者，均接受了黏弹剂辅助的 DALK 治疗。平均随访时间为 19.91±15.80 个月（6-48 个月）。
所有患者均成功完成了 DALK，术中无任何并发症。末次随访时，除 1 只眼因术前存在青光眼性视神经萎缩而视力未提高外，其余眼的视力均较术前有明显改善。1 例患者术后最佳矫正视力无提高，因为术前已经存在青光眼性视神经萎缩。8 只眼的最佳矫正视力≥20/80，除 2 例外，所有患者在末次随访时均有透明的移植物。无患者出现移植物感染的证据。
黏弹剂辅助 DALK 是治疗单纯疱疹性角膜炎后角膜水疱的一种有效治疗选择。
