Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Department of Ophthalmology, All India Institute of Medical Sciences Dr RP Centre for Ophthalmic Sciences, New Delhi, India.
Br J Ophthalmol. 2022 Jan;106(1):1-13. doi: 10.1136/bjophthalmol-2020-318092. Epub 2021 Jan 4.
Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft. Management of a detached graft involves secondary interventions such as rebubbling, suturing and regrafts. In this review, we discuss graft detachment in different types of endothelial keratoplasty techniques including Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty; with emphasis on incidence, risk factors, preventive measures and their management.
移植物脱离是内皮角膜移植术最常见的并发症。随着内皮角膜移植术领域的不断发展，我们对移植物脱离的危险因素及其处理的理解也在不断发展。文献中描述了各种预防措施，包括供体移植物的预浸泡、前房填塞、通气切口、缝线以防止移植物脱位。脱离移植物的处理包括二次干预，如重新充气、缝合和再移植。在这篇综述中，我们讨论了不同类型的内皮角膜移植技术中的移植物脱离，包括撕除型 Descemet 膜内皮角膜移植术、撕除型自动化 Descemet 膜内皮角膜移植术和 Descemet 膜内皮角膜移植术；重点讨论了发病率、危险因素、预防措施及其处理。
