Kam Ka Wai, Young Alvin L
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Case Rep Transplant. 2013;2013:631702. doi: 10.1155/2013/631702. Epub 2013 Mar 3.
A thirty-year-old Chinese man with a history of severe trauma to his right eye, with secondary sectoral aniridia and multiple operations including intraocular lens insertion more than fifteen years ago, underwent an uneventful Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) for his pseudophakic bullous keratopathy in a tertiary hospital in Hong Kong. The nature of his previous operations was unknown to the surgeon at the time of transplant. On postoperative day one, the graft was not present in the anterior chamber. Fundal view was limited because of corneal oedema. B-scan ultrasonography could not detect any definite presence of a donor button in the posterior segment as gas was present in the vitreous cavity. The patient was instructed to lie prone full time, and on postoperative day three, the graft was found to be reattached to the stroma with spontaneous resolution of corneal oedema, indicating restoration of pump function of endothelium graft. This is the first case of spontaneous reattachment of a posteriorly dislocated endothelial graft without surgical intervention or abandonment of the grafted endothelial button.
一名30岁的中国男性，右眼有严重外伤史，继发扇形无虹膜症，曾接受多次手术，包括15年多前的人工晶状体植入术。他在香港一家三级医院因假晶状体大泡性角膜病变接受了一次顺利的Descemet膜剥离自动内皮角膜移植术（DSAEK）。移植时，外科医生并不清楚他之前手术的具体情况。术后第一天，前房内未见移植片。由于角膜水肿，眼底检查受限。B超检查无法在眼后段明确检测到供体植片，因为玻璃体腔内有气体。患者被要求全天俯卧，术后第三天，发现移植片重新附着于基质，角膜水肿自行消退，表明内皮移植片的泵功能恢复。这是首例后脱位内皮移植片在未进行手术干预或丢弃移植的内皮植片情况下自发重新附着的病例。
