Passani Andrea, Sframeli Angela Tindara, Loiudice Pasquale, Nardi Marco
Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy.
Saudi J Ophthalmol. 2017 Jan-Mar;31(1):58-60. doi: 10.1016/j.sjopt.2017.01.003. Epub 2017 Feb 16.
A 31-year-old healthy male underwent deep anterior lamellar keratoplasty with big-bubble technique for treatment of keratoconus in his right eye. One week after surgery, he presented with detachment of the endothelium-Descemet complex with formation of a double anterior chamber, despite the apparent absence of an intraoperative Descemet membrane rupture. A subsequent intervention with the intent to relocate the corneal graft button was not effective, because the detachment appeared again one day later. The authors hypothesized that, at the time of the stromal dissection with big bubble technique, a small amount of air penetrated into the anterior chamber, creating a false pathway through the trabecular meshwork. The aqueous humor then penetrated the graft flowing through the false pathway, causing the endothelium-Descemet detachment. The persistence of that pathway, even after the intervention of graft repositioning, caused the failure of the latter procedure and persistence of the double chamber. We decided to wait and observe. The double anterior chamber spontaneously resolved in approximately three months.
一名31岁的健康男性因右眼圆锥角膜接受了深板层角膜移植术（大泡技术）。术后一周，尽管术中后弹力层明显未破裂，但他出现了内皮-后弹力层复合体脱离并形成双前房。随后试图重新定位角膜植片纽扣的干预措施无效，因为一天后脱离再次出现。作者推测，在使用大泡技术进行基质剥离时，少量空气进入前房，通过小梁网形成了一条假通道。房水随后通过该假通道穿透植片，导致内皮-后弹力层脱离。即使在进行植片重新定位干预后，该通道仍然存在，导致后一手术失败以及双前房持续存在。我们决定等待观察。双前房在大约三个月后自行消退。
