Chen Peiqing, Zhu Yanan, Yao Ke
Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou, Zhejiang, 310009, China.
BMC Ophthalmol. 2017 Sep 16;17(1):169. doi: 10.1186/s12886-017-0566-4.
Femtosecond laser-assisted cataract surgery (FLACS) has grown in popularity among ophthalmologists as a novel technique. However, descemet membrane detachment (DMD) began to be found as the complication after FLACS. We report a case of serious DMD following FLACS due to the inappropriate incision design.
An 85-year-old man with apparent cornea arcus senilis underwent femtosecond laser-assisted cataract surgery in his right eye. A biplanar model was chosen for the main incision. A serious descemet membrane detachment (DMD) occurred at the end of phacoemulsification, which was connected with the main incision. However, the surgeon confused it with the transient swelling of corneal endothelium, and did not treated DMD timely. DMD was confirmed by anterior segment optical coherence tomography (AS-OCT) at the postoperative 1-month follow-up. Eventually DMD was resolved by intracameral perfluropropane (C3F8) gas injection.
This case suggests that a careful incision separation and a triplanar incision design in FLACS may reduce the incidence of DMD in cataract surgery.
飞秒激光辅助白内障手术（FLACS）作为一种新技术在眼科医生中越来越受欢迎。然而，飞秒激光辅助白内障手术后开始发现后弹力层脱离（DMD）这一并发症。我们报告一例因切口设计不当导致飞秒激光辅助白内障手术后严重后弹力层脱离的病例。
一名85岁患有明显角膜老年环的男性患者右眼接受了飞秒激光辅助白内障手术。主切口选择双平面模型。在超声乳化结束时发生了严重的后弹力层脱离（DMD），且与主切口相连。然而，手术医生将其与角膜内皮的短暂肿胀相混淆，未及时治疗后弹力层脱离。术后1个月随访时通过眼前节光学相干断层扫描（AS-OCT）确诊为后弹力层脱离。最终通过前房内注入全氟丙烷（C3F8）气体使后弹力层脱离得到解决。
该病例表明，飞秒激光辅助白内障手术中仔细的切口分离和三平面切口设计可能会降低白内障手术中后弹力层脱离的发生率。
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