Mittal Vikas, Mittal Ruchi, Maheshwari Rajat
Department of Cornea and Anterior Segment Services, Sanjivni Eye Care, Model Town, Ambala City, Haryana, India.
Indian J Ophthalmol. 2014 May;62(5):651-3. doi: 10.4103/0301-4738.118435.
A 38-year-old woman presented with corneal decompensation in left eye secondary to irido-corneal endothelial (ICE) syndrome. She underwent simultaneous Descemet's stripping endothelial keratoplasty (DSEK) and clear lens extraction with posterior chamber intraocular lens implantation. The surgery was accomplished comfortably without rupture of peripheral anterior synechiae (PAS). 5 weeks postoperatively, the graft was attached, the cornea was clear and best-corrected visual acuity improved from 20/400 to 20/30. DSEK combined with clear lens extraction appears to be an effective measure to treat corneal decompensation in patients with ICE syndrome. Associated lens extraction in such cases increases the working space in anterior chamber for DSEK, which minimizes the intra-operative graft manipulation. This also avoids a future difficult cataract surgery in the presence of PAS and an endothelial graft, which may increase the chances of graft survival.
一名38岁女性因虹膜角膜内皮（ICE）综合征继发左眼角膜失代偿前来就诊。她接受了同期的后弹力层剥脱内皮角膜移植术（DSEK）以及透明晶状体摘除联合后房型人工晶状体植入术。手术顺利完成，周边前粘连（PAS）未破裂。术后5周，移植片附着良好，角膜透明，最佳矫正视力从20/400提高到了20/30。DSEK联合透明晶状体摘除似乎是治疗ICE综合征患者角膜失代偿的有效措施。在此类病例中进行相关的晶状体摘除可增加前房内DSEK的操作空间，从而将术中移植片的操作减至最少。这也避免了未来在存在PAS和内皮移植片的情况下进行困难的白内障手术，而这可能会增加移植片存活的几率。
