穿透性角膜移植术中的双板层角膜后弹力层剥除内皮角膜移植术
A double Descemet's stripping endothelial keratoplasty on a penetrating keratoplasty.
作者信息
Goh Li Yen, Elalfy Mohamed, Mohamed Ghoz Noha, Dua Harminder
机构信息
Ophthalmology, Kingston Hospital NHS Trust, Kingston upon Thames, London, UK.
Academic Section of Ophthalmology and Visual Sciences, Nottingham University Hospitals NHS Trust, Nottingham, UK.
出版信息
BMJ Case Rep. 2017 May 9;2017:bcr-2016-218257. doi: 10.1136/bcr-2016-218257.
A patient with keratoconus underwent a penetrating keratoplasty (PK) in his right eye. This failed after 12 years following phacoemulsification surgery. A Descemet's stripping endothelial keratoplasty (DSEK) was carried out which failed and detached after 4 months. Subsequently, a second DSEK was performed which failed after 2 months but remained attached. This graft was retained in the cornea and a third DSEK button was placed without removing the failed DSEK graft. The cornea cleared well and patient's vision was 6/9 at 18 months postsurgery. Optical coherence tomography showed the two DSEK grafts closely applied to each other and to the recipient cornea. Stripping a failed DSEK graft performed for a previous failed PK carries the risk of internal dehiscence of the PK graft-host junction. This was avoided by placing the second DSEK graft on the failed previous DSEK graft with good visual outcome indicating that this option can be clinically considered.
一名圆锥角膜患者右眼接受了穿透性角膜移植术（PK）。该手术在白内障超声乳化术后12年失败。随后进行了后弹力层剥脱性角膜内皮移植术（DSEK），但术后4个月失败且植片脱离。接着再次进行DSEK，术后2个月失败但植片仍附着。该移植片保留在角膜中，未移除失败的DSEK移植片的情况下放置了第三片DSEK植片。术后18个月时角膜情况良好，患者视力为6/9。光学相干断层扫描显示两片DSEK移植片彼此紧密贴合且与受体角膜贴合。为先前失败的PK手术而进行的失败DSEK移植片剥除操作存在PK移植片与宿主结合处内部裂开的风险。通过将第二片DSEK移植片置于先前失败的DSEK移植片上避免了这种情况，良好的视觉效果表明该方法可在临床上予以考虑。
Zotero 插件