Karadag Remzi, Aykut Veysel, Esen Fehim, Oguz Halit, Demirok Ahmet
Department of Ophthalmology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe, Istanbul, Turkey.
GMS Ophthalmol Cases. 2020 Feb 14;10:Doc02. doi: 10.3205/oc000129. eCollection 2020.
To report a new technique for Descemet's membrane endothelial keratoplasty (DMEK) in aphakic and vitrectomized eyes. A 56-year-old man presented with corneal decompensation in the left eye after combined pars plana vitrectomy and lensectomy for the management of a traumatic eye injury. DMEK graft and recipient bed were prepared as regular. The posterior half of the donor stroma was dissected with a crescent knife to form a temporary stromal barrier tissue. The prepared donor stromal tissue was implanted into the anterior chamber (AC) to form a barrier over the iris and pupilla. Then, the endothelial graft was safely injected into the anterior chamber and deployed by gently tapping on the corneal surface. Air tamponade was applied into the AC for 10 minutes to allow the graft to attach. Afterwards, the stromal barrier tissue was removed through the main incision and the AC was refilled with air tamponade. There were no intraoperative or postoperative complications during 1-month follow-up. Insertion of a temporary posterior stromal tissue as a barrier over the iris and pupilla successfully provided AC stability and prevented posterior dislocation of the graft or air tamponade. This new technique was a safe and effective approach for DMEK in aphakic and vitrectomized eyes.
报告一种在无晶状体和玻璃体切除术后眼中进行Descemet膜内皮角膜移植术（DMEK）的新技术。一名56岁男性因外伤性眼损伤接受了玻璃体切除术和平坦部晶状体切除术后，左眼出现角膜失代偿。按常规制备DMEK移植物和受体床。用新月形刀解剖供体基质的后半部分，形成临时基质屏障组织。将制备好的供体基质组织植入前房（AC），在虹膜和瞳孔上方形成屏障。然后，将内皮移植物安全地注入前房，并通过轻轻敲击角膜表面展开。向AC内注入空气填塞10分钟，以使移植物附着。之后，通过主切口移除基质屏障组织，并用空气填塞重新填充AC。在1个月的随访期间未出现术中或术后并发症。插入临时后基质组织作为虹膜和瞳孔上方的屏障，成功地提供了AC稳定性，并防止了移植物或空气填塞的后脱位。这种新技术是无晶状体和玻璃体切除术后眼中DMEK的一种安全有效的方法。
