Rosetta P, Legrottaglie E F, Vinciguerra R, Vinciguerra P
Eye Center, Humanitas University, Humanitas Clinical and Research Hospital, Rozzano, Italy.
St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Case Rep Ophthalmol Med. 2017;2017:5804965. doi: 10.1155/2017/5804965. Epub 2017 Oct 31.
To report a case of a Descemet membrane's (DM) detachment after radial keratotomy (RK).
A patient (male) underwent RK (16 cuts) 20 years before referring to the Eye Center of Humanitas (Milan) for a progressive visual loss. The slit-lamp examination showed severe corneal stromal edema and a large DM detachment in the lower half of the cornea. Anterior segment optical coherence tomography (AS-OCT) and endothelial cells count confirmed DM detachment and endothelial cells damage. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) was planned and topical hypertonic therapy was prescribed before the surgery.
Eight months later, the patient mentioned a spontaneous increase in visual acuity; the slit-lamp examination and the AS-OCT displayed a recovery of corneal transparency with a resolution of DM detachment.
This is the first report of spontaneous DM detachment with severe corneal edema after RK. We suggest that hypertonic therapy may reduce DM detachment and restore corneal transparency.
报告一例放射状角膜切开术（RK）后后弹力层（DM）脱离的病例。
一名男性患者在转诊至米兰胡曼itas眼科中心之前20年接受了RK手术（16切口），出现渐进性视力丧失。裂隙灯检查显示角膜基质严重水肿，角膜下半部有大面积DM脱离。眼前节光学相干断层扫描（AS-OCT）和内皮细胞计数证实了DM脱离和内皮细胞损伤。计划进行后弹力层剥除自动内皮角膜移植术（DSAEK），并在手术前给予局部高渗治疗。
八个月后，患者自述视力自发提高；裂隙灯检查和AS-OCT显示角膜透明度恢复，DM脱离消退。
这是首例关于RK术后出现自发性DM脱离并伴有严重角膜水肿的报告。我们建议高渗治疗可能会减少DM脱离并恢复角膜透明度。
