Romanazzi Filippo, Morano Anna, Caccavale Antonio
Department of Ophthalmology, Abbiategrasso Hospital, ASST Ovest Milanese, Abbiategrasso, Italy.
Case Rep Ophthalmol. 2020 Aug 6;11(2):423-429. doi: 10.1159/000509262. eCollection 2020 May-Aug.
An 80-year-old male was referred to our hospital for chronic bullous keratopathy in the right eye. Ten years before, he was affected by an attack of primary acute angle closure glaucoma in high hyperopia and Fuchs' endothelial dystrophy. A bilateral iridotomy was performed. Thereafter, the patient developed an endothelial decompensation in the left eye, and, in another hospital, he underwent an open-sky combined cataract extraction and penetrating keratoplasty. Our surgical approach for the right eye consisted of phacoemulsification and, after 1 month, a Descemet's stripping automated endothelial keratoplasty (DSAEK). After the procedure, an interface fluid was suspected, and an anterior segment optical coherence tomography (OCT) confirmed it. The graft was well centered but thickened, showing no movement in the anterior chamber, adherent to the periphery of the recipient cornea but with a pool of fluid in the center. Seven days postoperatively, an anterior segment OCT showed initial signs of reabsorption of the fluid. On day 45, the graft was adherent with normal thickness and the interface fluid had completely disappeared. The corneal stroma was clear, but a faint interface opacity appeared and is still present. We obtained a good surgical result and best corrected visual acuity was 7/10 at postoperative month 4. No further surgical procedures are scheduled.
一名80岁男性因右眼慢性大疱性角膜病变被转诊至我院。10年前，他患有原发性急性闭角型青光眼发作，伴有高度远视和富克斯内皮营养不良。进行了双侧虹膜切开术。此后，患者左眼出现内皮失代偿，并在另一家医院接受了开放式联合白内障摘除和穿透性角膜移植术。我们对右眼的手术方法包括超声乳化术，1个月后进行了Descemet膜剥脱自动内皮角膜移植术（DSAEK）。术后怀疑有界面液，前段光学相干断层扫描（OCT）证实了这一点。移植物居中良好但增厚，在前房内无移动，与受体角膜周边粘连，但中央有一液池。术后7天，前段OCT显示液体积聚开始出现吸收迹象。在第45天，移植物粘连，厚度正常，界面液已完全消失。角膜基质清晰，但出现了淡淡的界面混浊，目前仍然存在。我们获得了良好的手术效果，术后4个月最佳矫正视力为7/10。未安排进一步的手术。
