针对富克斯角膜内皮营养不良的后弹力层撕除术
Descemetorhexis for Fuchs' dystrophy.
作者信息
Moloney Gregory, Chan U-Teng, Hamilton Alex, Zahidin Aida Mohd, Grigg John R, Devasahayam Raj N
机构信息
Discipline of Ophthalmology, Sydney Medical School, The University of Sydney; Sydney Eye Hospital, Sydney, Australia.
Sydney Eye Hospital, Sydney, Australia.
出版信息
Can J Ophthalmol. 2015 Feb;50(1):68-72. doi: 10.1016/j.jcjo.2014.10.014. Epub 2014 Oct 31.
OBJECTIVE
To describe 2 cases of spontaneous corneal clearing after Descemetorhexis: 1 after iatrogenic trauma (Case 1) and 1 as an intentional surgical intervention for Fuchs endothelial dystrophy (Case 2).
METHODS
Retrospective case reports.
RESULTS
Full corneal clarity was observed to restore at approximately 1 month after surgery in both cases. Central endothelial cell counts were recorded as 753 and 731 cells/mm(2) in cases 1 and 2, respectively, at last follow-up. Best spectacle corrected visual acuity (BSCVA) at was 6/6 in both cases at 6 weeks and is retained at 9 months.
CONCLUSIONS
Selective Descemetorhexis may offer visual rehabilitation without the need for a graft in select cases of Fuchs endothelial dystrophy. Descemetopexy in anticipation of corneal clearing is a viable initial strategy in cases of iatrogenic Descemet trauma with detachment.
目的
描述2例后弹力层撕除术后角膜自发清亮的病例：1例为医源性创伤后（病例1），1例为针对Fuchs内皮营养不良的有意手术干预（病例2）。
方法
回顾性病例报告。
结果
两例患者术后约1个月均观察到角膜完全恢复清亮。病例1和病例2末次随访时中央内皮细胞计数分别为753个/mm²和731个/mm²。6周时两例患者的最佳矫正视力（BSCVA）均为6/6，9个月时仍保持该视力。
结论
对于部分Fuchs内皮营养不良病例，选择性后弹力层撕除术可能无需植片即可实现视力康复。对于医源性后弹力层创伤伴脱离且预期角膜能自行清亮的病例，预先进行后弹力层固定术是一种可行的初始策略。
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