Department of Ophthalmology, Western Galilee-Nahariya Medical Center, Nahariya, Israel.
Cornea. 2011 Jun;30(6):709-11. doi: 10.1097/ICO.0b013e3181fb8378.
To describe the trimming of a glaucoma shunt tube with Descemet membrane endothelial keratoplasty (DMEK) for the treatment of endothelial decompensation caused by tube-endothelium touch.
An 84-year-old man with pseudoexfoliative glaucoma OU had endothelial decompensation because of the touch of the tube of an Ahmed glaucoma valve at the corneal endothelium OS. The best-corrected visual acuity decreased from 20/60 to counting fingers at 3 feet. The patient underwent uncomplicated trimming of the shunt tube and DMEK.
After surgery, the cornea became clear, and the best-corrected visual acuity improved to 20/60. The intraocular pressure remained normal (8-12 mm Hg) without antiglaucoma medications, and endothelial cell count remained stable in a follow-up of 12 months. No complications were encountered.
Glaucoma shunt tube trimming with DMEK may be considered in cases of endothelial decompensation because of tube-endothelium touch and may replace penetrating keratoplasty and other posterior lamellar procedures for such cases.
描述经 Descemet 膜内皮角膜移植术（DMEK）修剪青光眼引流管，以治疗因管-内皮接触导致的内皮失代偿。
一名 84 岁男性，双眼患有原发性开角型青光眼合并假性剥脱性青光眼，由于左眼 Ahmed 青光眼阀管接触角膜内皮，出现内皮失代偿。最佳矫正视力从 20/60 降至 3 英尺数指。患者接受了单纯的引流管修剪和 DMEK 手术。
术后角膜透明，最佳矫正视力提高至 20/60。眼内压保持正常（8-12mmHg），无需抗青光眼药物，随访 12 个月内皮细胞计数稳定。未出现并发症。
对于因管-内皮接触导致的内皮失代偿，可以考虑进行青光眼引流管修剪与 DMEK，这种情况下可能替代穿透性角膜移植术和其他后板层手术。
