*Department of Ophthalmology, Dongguk University, Ilsan Hospital, Koyang, Kyunggido, South Korea; and †Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Cornea. 2013 Dec;32(12):1607-9. doi: 10.1097/ICO.0b013e3182a6d0cb.
To report a case of non-Descemet stripping Descemet membrane endothelial keratoplasty (nDMEK) in a patient with pseudophakic bullous keratopathy.
A 70-year-old man underwent an nDMEK in his right eye, which suffered from pseudophakic bullous keratopathy after a complicated cataract surgery was performed. Under local anesthesia, an 8-mm sized round Descemet membrane and endothelial cell graft (DMEK graft), harvested from an 85-year-old male donor cornea, were transplanted without stripping the recipient's Descemet membrane. The patient was examined at 1 week, 2 weeks, 3 weeks, 4 weeks, 2 months, 4 months, and 6 months after the surgery took place. Optical coherence tomography, Scheimpflug imaging (Pentacam, Oculus), and specular microscopy were performed.
Graft detachment was observed at 1 and 2 weeks after the surgery, but this was successfully resolved with C3F8 gas tamponade in the anterior chamber. Thereafter, no graft detachment was observed, and the cornea remained clear 6 months after the surgery. The best-spectacle corrected visual acuity was improved from 20/100 to 20/25, and central corneal pachymetry was improved from 713 to 570 µm. No ocular complication was detected at the final visit.
An nDMEK was successfully performed in a patient with pseudophakic bullous keratopathy and resulted in a good visual outcome.
报告 1 例假性剥脱性大疱性角膜病变患者行非撕囊式 Descemet 膜内皮角膜移植术（nDMEK）的病例。
1 名 70 岁男性患者因复杂白内障手术后发生假性剥脱性大疱性角膜病变，于右眼行 nDMEK。在局部麻醉下，从 1 名 85 岁男性供体角膜上切取 8mm 大小的圆形 Descemet 膜和内皮细胞移植物（DMEK 移植物），未撕除受者的 Descemet 膜即进行移植。术后 1 周、2 周、3 周、4 周、2 个月、4 个月和 6 个月对患者进行检查。进行光学相干断层扫描、Scheimpflug 成像（Pentacam，Oculus）和共焦显微镜检查。
术后 1 周和 2 周观察到移植物脱离，但在前房内用 C3F8 气体填充成功解决。此后，未再观察到移植物脱离，术后 6 个月角膜仍保持透明。最佳矫正视力从 20/100 提高到 20/25，中央角膜厚度从 713µm 改善至 570µm。最终随访时未发现眼部并发症。
对假性剥脱性大疱性角膜病变患者成功实施 nDMEK，获得了良好的视力结果。
