Ophthalmology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
BMJ Case Rep. 2021 Jun 15;14(6):e237541. doi: 10.1136/bcr-2020-237541.
A 78-year-old pseudophakic women with pseudoexfoliation glaucoma and 6-year history of prior Descemet's stripping automated endothelial keratoplasty (DSAEK) underwent deep sclerectomy for a poorly controlled glaucoma. Exposure of the trabeculo-Descemet's window (TDW), showed a very poor drainage. An attempt to dissect the fibrous tissue off the TDW resulted in perforation of the window needing peripheral iridectomy, followed by a white fibrous band which had to be excised to prevent blockade of the filtration channel. Postoperatively, there was complete detachment of the endothelial graft on day 1 with an intraocular pressure of 20 mm Hg. She was commenced on topical steroids and listed for a revisionary DSAEK in 6 weeks but when reviewed in a month postoperatively, a spontaneous reattachment of the endothelial graft was seen.
一位 78 岁的女性假晶状体眼，患有假性剥脱性青光眼，此前有 6 年的 Descemet 膜撕除自动内皮角膜移植术（DSAEK）病史，因青光眼控制不佳而行深层巩膜切除术。暴露小梁-Descemet 窗（TDW），显示出非常差的引流。试图将 TDW 上的纤维组织剥离，导致窗口穿孔，需要进行周边虹膜切除术，随后是一条白色纤维带，必须切除以防止滤过通道阻塞。术后第 1 天，内皮移植物完全脱离，眼压为 20mmHg。她开始局部应用皮质类固醇，并在 6 周内进行了翻修 DSAEK 的登记，但在术后 1 个月复查时，内皮移植物自发重新附着。
