Cornea & External Diseases Department, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom; and.
Department of Health's NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom.
Cornea. 2021 Aug 1;40(8):1079-1084. doi: 10.1097/ICO.0000000000002713.
We present a technique that preserves good vision in paracentral macroperforations and avoids challenges of tectonic lamellar or penetrating keratoplasty in eyes with poor visual potential.
A wet laboratory was implemented for mini-Descemet stripping endothelial keratoplasty to seal macroperforations ab interno. This included a suture support technique designed to prevent graft herniation. We also present 3 cases who were treated successfully with this technique.
The laboratory test confirmed that mini-Descemet stripping endothelial keratoplasty can successfully seal macroperforations without the need of large incisions. The minidisc is introduced through the perforation, and a double mattress suture prevents graft herniation. The technique allowed us to preserve 20/15 unaided vision in a case with paracentral macroperforation. It also restored eye globe integrity and achieved long-term stability in 2 cases with limbal stem-cell deficiency.
Mini-Descemet stripping-automated endothelial keratoplasty technique can be an alternative approach to avoid poor visual outcomes of tectonic keratoplasty in paracentral perforations. It also offers host tissue preservation in eyes with high risk of rejection for tectonic grafts.
我们提出了一种技术，可在旁中心大穿孔中保留良好的视力，并避免在视力潜力差的眼睛中进行组织层状或穿透性角膜移植的挑战。
在实验室中实施了 mini-Descemet 剥离内皮角膜移植术，以从内部封闭大穿孔。这包括一种缝线支撑技术，旨在防止移植物疝出。我们还介绍了 3 例成功接受该技术治疗的病例。
实验室测试证实，mini-Descemet 剥离内皮角膜移植术可成功封闭大穿孔，而无需大切口。将 minidisc 通过穿孔引入，并使用双褥式缝线防止移植物疝出。该技术使我们能够在一例旁中心大穿孔的患者中保留 20/15 的裸眼视力。它还在 2 例伴有边缘干细胞缺陷的患者中恢复了眼球完整性，并实现了长期稳定。
mini-Descemet 剥离自动内皮角膜移植术技术可以作为避免旁中心穿孔中组织性角膜移植术不良视力结果的替代方法。它还为具有高排斥风险的组织移植物的眼球提供了组织保存。
