曲安奈德辅助剥除术治疗后弹力层残留

Tyring Ariel, Chang Oliver, Jung Hoon

Department of Ophthalmology, University of Washington, Seattle, Washington, USA.

Department of Veterans Affairs Puget Sound, Seattle, Washington, USA.

Case Rep Ophthalmol. 2018 Mar 22;9(1):227-231. doi: 10.1159/000487706. eCollection 2018 Jan-Apr.

We present a case of decreased vision due to the presence of retained Descemet membrane (DM) following Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP). A 78-year-old male presented postoperatively from PKP after previous failed DSAEK with retained DM. We present a unique technique for combined surgical resection using bimanual vitrectomy and forceps excision assisted by triamcinolone acetonide for membrane visualization. Histopathological evaluation confirmed incomplete DM removal during the PKP. With surgical excision, there was an improvement in best spectacle-corrected visual acuity from 20/80 to 20/30.

我们报告了1例在Descemet膜剥除自动角膜内皮移植术（DSAEK）和穿透性角膜移植术（PKP）后因残留Descemet膜（DM）而导致视力下降的病例。一名78岁男性患者，此前DSAEK失败并残留DM，之后接受了PKP手术，术后前来就诊。我们介绍了一种独特的联合手术切除技术，即使用双手操作玻璃体切除术，并在曲安奈德辅助下用镊子切除，以实现膜的可视化。组织病理学评估证实PKP期间DM切除不完全。通过手术切除，最佳矫正视力从20/80提高到了20/30。