非Descemet膜剥除自动内皮角膜移植术后部分移植片脱离情况下的角膜自发清除
Spontaneous Corneal Clearance in the Presence of a Partially Detached Graft after Non-Descemet Stripping Automated Endothelial Keratoplasty.
作者信息
Droutsas Konstantinos, Lazaridis Apostolos, Koutsandrea Chrysanthi, Chatzistefanou Klio I, Moschos Marilita M, Sekundo Walter
机构信息
Department of Ophthalmology, Philipps University, Marburg, Germany; The Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; First Department of Ophthalmology, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece.
Department of Ophthalmology, Philipps University, Marburg, Germany; First Department of Ophthalmology, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece.
出版信息
Case Rep Ophthalmol. 2016 May 24;7(2):321-7. doi: 10.1159/000443632. eCollection 2016 May-Aug.
PURPOSE
To report the explantation of a detached and opaque donor disc as an alternative to secondary keratoplasty in a case of persistent graft detachment followed by spontaneous clearance of the recipient cornea after non-Descemet stripping automated endothelial keratoplasty (non-DSAEK).
RESULTS
Four months after graft explantation, BSCVA was 0.5 and endothelial cell density (ECD) was 1,221 cells/m(2). After 13 months, BSCVA was still 0.6 while ECD had fell to 800, and 2 years later, the endothelium decompensated. BSCVA was 0.3 and ECD was not measurable.
CONCLUSIONS
To our knowledge this is the first report of explantation of an endothelial graft as an alternative to re-keratoplasty in a case of spontaneous corneal clearance. This minimally invasive treatment may be considered in similar cases. However, due to the ongoing loss of endothelial cells after endothelial keratoplasty, a re-keratoplasty may still be needed in the long term.
目的
报告一例在非Descemet膜剥除自动内皮角膜移植术（non-DSAEK）后发生持续性移植片脱离，随后受体角膜自发清亮的情况下，将脱离且混浊的供体植片取出作为二期角膜移植替代方法的病例。
结果
移植片取出4个月后，最佳矫正视力（BSCVA）为0.5，内皮细胞密度（ECD）为1221个细胞/mm²。13个月后，BSCVA仍为0.6，而ECD降至800，2年后，内皮失代偿。BSCVA为0.3，ECD无法测量。
结论
据我们所知，这是首例在角膜自发清亮的情况下，将内皮移植片取出作为再次角膜移植替代方法的报告。对于类似病例可考虑这种微创治疗。然而，由于内皮角膜移植术后内皮细胞持续丢失，长期来看可能仍需要再次角膜移植。
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