Pujari Amar, Swamy Deepa R, Chaniyara Manthan Hasmukhbhai, Sharma Namrata
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
BMJ Case Rep. 2018 Oct 21;2018:bcr-2018-225593. doi: 10.1136/bcr-2018-225593.
A 60-year-old female patient with phacomorphic glaucoma underwent initial medical management to control the intraocular pressure (IOP). After 48 hours, a stable IOP was achieved and subsequently the patient was planned for phacoemulsification followed by intraocular lens implantation. There was initial difficulty while reconstructing the corneal wounds; however, phacoemulsification and IOL implantation were uneventful but during viscoelastic removal, an inadvertent Descemet's membrane detachment involving the central cornea was noted. Postoperatively corneal oedema persisted till 1 week, following which there was a gradual improvement with topical antibiotics, steroids and hyperosmotic agents. At the end of 6 months, the best corrected visual acuity was 20/25 with a central corneal thickness of 580 µm without any need for additional endothelial replacement surgery.
一名60岁的晶状体膨胀性青光眼女性患者接受了初步的药物治疗以控制眼压（IOP）。48小时后，眼压稳定，随后计划为患者进行超声乳化白内障吸除术并植入人工晶状体。重建角膜伤口时起初遇到困难；然而，超声乳化白内障吸除术和人工晶状体植入术过程顺利，但在清除粘弹剂时，发现中央角膜发生了意外的后弹力层脱离。术后角膜水肿持续了1周，之后使用局部抗生素、类固醇和高渗剂后逐渐好转。6个月末，最佳矫正视力为20/25，中央角膜厚度为580 µm，无需进行额外的内皮置换手术。
