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后弹力层脱离:白内障超声乳化手术中的一种术中并发症。

Descemet's Membrane Detachment: An Intraoperative Complication in Cataract Surgery with Phacoemulsification.

作者信息

González Ana Luisa, Silva Fermín, Barrientos Robinson, Paredes Fabricio

机构信息

Department of Ophthalmology, Research Department Clínica La Luz, 1148 Lima, Peru.

出版信息

Int Med Case Rep J. 2020 Dec 1;13:673-677. doi: 10.2147/IMCRJ.S283770. eCollection 2020.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6db/7718970/8ef4d39f819c/IMCRJ-13-673-g0001.jpg

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