González Ana Luisa, Silva Fermín, Barrientos Robinson, Paredes Fabricio
Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru.
Int Med Case Rep J. 2020 Dec 1;13:673-677. doi: 10.2147/IMCRJ.S283770. eCollection 2020.
Descemet's membrane detachment (DMD) is a complication fundamentally associated with cataract surgery, the subclinical presentation being higher than expected. There are many varied treatments, from simple observation to penetrating keratoplasty. We present a case report of a 78-year-old male patient, without comorbidities, who underwent cataract surgery with phacoemulsification plus intraocular lens implantation in the capsular bag of the left eye. During the intraoperative procedure, he presented a DMD (height of 350 um and length of 3 mm in Zone 1 according to the HELP algorithm), managed with adaptive viscoelastic under the soft-shell technique in the same operative act, injection of iso-expansile SF6 (20%) intracameral plus postural positioning for 2 hours carried out 48 hours after surgery plus intensive topical treatment with hypertonic sodium chloride and steroidal anti-inflammatory drugs. At 72 hours after the operation of the application of the gas bubble, he presented with a transparent cornea and a best-corrected visual acuity of 20/80, which finally for his ophthalmological control at 8 weeks presented definitive resolution of the case in the AS-OCT and with a BCVA of 20/30.
Descemet膜脱离（DMD）是一种与白内障手术密切相关的并发症，其亚临床表现高于预期。治疗方法多种多样，从简单观察到穿透性角膜移植术。我们报告一例78岁男性患者，无合并症，左眼行囊袋内白内障超声乳化吸除联合人工晶状体植入术。术中，他出现了DMD（根据HELP算法，在1区高度为350μm，长度为3mm），在同一手术中采用软壳技术下的自适应粘弹剂处理，术后48小时前房内注射等膨胀性SF6（20%）并体位保持2小时，同时联合高渗氯化钠和甾体类抗炎药进行强化局部治疗。在应用气泡手术后72小时，他的角膜透明，最佳矫正视力为20/80，最终在8周的眼科检查中，AS-OCT显示该病例得到明确解决，最佳矫正视力为20/30。
