Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK.
Int Ophthalmol. 2020 May;40(5):1285-1290. doi: 10.1007/s10792-020-01295-7. Epub 2020 Jan 25.
We present a variation in the slit-lamp microscope re-bubbling technique for DMEK detachment in which a paracentesis is used as a self-sealing valve.
Of twenty-eight consecutive DMEK cases, five (18%) required re-bubbling. A 20-gauge side port blade was used to make a paracentesis in the inferior temporal quadrant. A 30-gauge cannula mounted on a 3 ml syringe was employed to inject air using the paracentesis as a valve allowing better control over intraocular pressure and percentage anterior chamber air fill.
Graft re-attachment was achieved in all cases. One case required two re-bubbling procedures. There were no cases of pupil block glaucoma or other complications.
Slit-lamp re-bubbling is a practical and safe alternative to taking patients back to the operating room. Using a new paracentesis for valve action control over air injection with a blunt cannula adds better control and may help to reduce complications.
我们介绍了一种用于 DMEK 脱离的裂隙灯显微镜再充气技术的变异，其中使用房穿刺作为自密封阀。
在 28 例连续的 DMEK 病例中，有 5 例（18%）需要再充气。使用 20 号侧端口刀片在下颞象限处做房穿刺。使用安装在 3 毫升注射器上的 30 号套管通过房穿刺作为阀来注入空气，从而更好地控制眼内压和前房空气填充百分比。
所有病例均实现了移植物再附着。有 1 例需要进行两次再充气处理。没有发生瞳孔阻滞性青光眼或其他并发症。
与将患者带回手术室相比，裂隙灯再充气是一种实用且安全的替代方法。使用新的房穿刺来控制钝套管的空气注射，可以更好地控制，有助于减少并发症。
