Department of Ophthalmology, China Medical University Hospital, No. 2, Yuh Der Road, Taichung, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2013 Jun;251(6):1557-63. doi: 10.1007/s00417-013-2264-0. Epub 2013 Jan 29.
To describe a scleral indentation technique to enhance donor adherence in Descemet's stripping and automated endothelial keratoplasty (DSAEK) in patients with abnormal anterior segment.
In patients with visual potential, we performed transscleral fixation of a foldable intraocular lens (IOL) and DSAEK. In patients only for pain relief, we performed DSAEK without IOL implantation. During air tamponade, we injected only a medium air bubble instead of big bubble into anterior chamber and used scleral indentation technique as an aid. The position of the grafts was checked by the slit lamp and anterior segment optical coherence tomography (AS-OCT).
Five eyes of five patients of aphakic bullous keratopathy (ABK) or pseudophakic bullous keratopathy (PBK) with anterior chamber IOL (AC IOL) were included in this non-comparative interventional case series. The grafts attached well in all patients without any graft dislocation intraoperatively and during the follow-up period. There was no pupillary block or peripheral anterior synechiae postoperatively.
Scleral indentation technique with or without transscleral fixation of a foldable IOL in DSAEK can facilitate the air tamponade and enhance the donor adherence in certain anterior segment abnormities.
描述一种巩膜凹陷技术，以增强在异常前段的患者中进行的撕囊和自动化内皮角膜移植术（DSAEK）中的供体附着。
在有视力潜力的患者中，我们进行了折叠式人工晶状体（IOL）的经巩膜固定和 DSAEK。对于仅为缓解疼痛的患者，我们进行了 DSAEK 而没有植入 IOL。在空气填充期间，我们仅在前房内注入中等气泡而不是大气泡，并使用巩膜凹陷技术作为辅助。通过裂隙灯和前节光学相干断层扫描（AS-OCT）检查移植物的位置。
这项非比较性介入性病例系列研究纳入了五例无晶状体泡状角膜病变（ABK）或人工晶状体后泡状角膜病变（PBK）患者的五眼。在所有患者中，移植物在手术中和随访期间均附着良好，没有任何移植物脱位。术后没有瞳孔阻滞或周边前粘连。
在 DSAEK 中，无论是否进行折叠式 IOL 的经巩膜固定，巩膜凹陷技术都可以促进空气填充，并增强某些前段异常中的供体附着。
