From Boston University School of Medicine (Kaufman), the Department of Ophthalmology (Nosé, Pineda), Massachusetts Eye and Ear Infirmary, Harvard Medical School, and Harvard Medical School (Lu), Boston, Massachusetts, USA.
From Boston University School of Medicine (Kaufman), the Department of Ophthalmology (Nosé, Pineda), Massachusetts Eye and Ear Infirmary, Harvard Medical School, and Harvard Medical School (Lu), Boston, Massachusetts, USA.
J Cataract Refract Surg. 2017 Nov;43(11):1471-1475. doi: 10.1016/j.jcrs.2017.10.028.
A 58-year-old woman with bilateral Fuchs endothelial corneal dystrophy presented with predominantly central guttata in the left eye causing visually significant stromal edema. A 4.0 mm descemetorhexis without endothelial keratoplasty was performed. At the 6-week follow-up, the central cornea had cleared completely and the central endothelial cell density (ECD) was 541 cells/mm. The central corneal clearing remained stable for 2 years after the procedure; however, vision declined because of a visually significant cataract in the left eye. Uneventful phacoemulsification with intraocular lens implantation was performed with a target refraction of -0.50 diopters. At 1.5 months postoperatively, the uncorrected distance visual acuity was 20/20 with a manifest refraction of -0.25 -0.25 × 60 and the central ECD was 2373 cells/mm (increased from 1471 cells/mm prior to phacoemulsification). Cataract surgery by phacoemulsification years after descemetorhexis without endothelial keratoplasty appears to be well-tolerated, with good clinical and predictive refractive outcomes.
一位 58 岁女性患有双侧 Fuchs 内皮角膜营养不良，左眼主要表现为中央颗粒状病变，导致明显的基质水肿。行 4.0mm 撕囊术，未行内皮角膜移植术。术后 6 周随访时，中央角膜完全透明，中央角膜内皮细胞密度（ECD）为 541 个细胞/mm。术后 2 年，中央角膜透明稳定；然而，由于左眼出现明显白内障，视力下降。左眼行超声乳化白内障吸除术联合人工晶状体植入术，目标屈光度为-0.50 屈光度。术后 1.5 个月，未矫正远视力为 20/20，矫正视力为-0.25-0.25×60，中央 ECD 为 2373 个细胞/mm（高于超声乳化白内障吸除术前的 1471 个细胞/mm）。撕囊术后多年行超声乳化白内障吸除术治疗白内障，似乎耐受性良好，具有良好的临床和预测性屈光效果。
