Samarawickrama Chameen, Beltz Jacqueline, Chan Elsie
University of Sydney, Sydney 2000, Australia; Royal Victorian Eye and Ear Hospital, Melbourne 3002, Australia.
Royal Victorian Eye and Ear Hospital, Melbourne 3002, Australia; Centre for Eye Research Australia, University of Melbourne, Melbourne 3002, Australia.
Int J Ophthalmol. 2016 Dec 18;9(12):1839-1842. doi: 10.18240/ijo.2016.12.23. eCollection 2016.
Descemet's membrane detachments (DMD) are relatively common after cataract surgery and most do not require any treatment. However, if large DMD are not treated appropriately, significant visual morbidity can ensue. We aim to develop a guideline for the management of DMD post cataract surgery based on a retrospective review of all cases encountered at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia over a 4-year period from 2010 to 2014. We suggest conservative management if the visual axis is not involved; however, after 3mo surgical intervention may be warranted to prevent corneal sequelae. In cases where the visual axis is involved we suggest early intervention with air tamponade. The main risk factor for irreversible corneal oedema and subsequent endothelial transplant appears to be direct endothelial trauma rather than the DMD itself.
后弹力层脱离（DMD）在白内障手术后相对常见，大多数情况下无需任何治疗。然而，如果大的DMD未得到适当治疗，可能会导致严重的视力损害。我们旨在通过回顾澳大利亚墨尔本皇家维多利亚眼耳医院在2010年至2014年4年期间遇到的所有病例，制定一份白内障手术后DMD管理指南。如果视轴未受累，我们建议采取保守治疗；然而，3个月后可能需要进行手术干预以预防角膜后遗症。在视轴受累的情况下，我们建议早期采用空气填塞进行干预。不可逆角膜水肿及随后进行内皮移植的主要危险因素似乎是直接的内皮损伤，而非DMD本身。
