穿透性角膜移植术后再次行 Rebubbling 时发生前弹力层撕脱性角膜穿通伤：病例报告。
Blast Wound Dehiscence During Descemet Membrane Endothelial Keratoplasty Rebubbling in a Previous Penetrating Keratoplasty: A Case Report.
机构信息
The Royal Liverpool University Hospital, Liverpool, United Kingdom.
Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
出版信息
Cornea. 2022 Jul 1;41(7):914-916. doi: 10.1097/ICO.0000000000002838. Epub 2021 Jul 27.
PURPOSE
The purpose of this study was to describe a rare complication of Descemet membrane endothelial keratoplasty (DMEK) rebubbling.
METHODS
An 86-year-old woman with bilateral penetrating keratoplasty (PK) performed 20 years previously for Fuchs endothelial dystrophy underwent DMEK surgery for endothelial corneal decompensation in the left eye. Surgery was complicated in the postoperative period by repeated DMEK graft detachments requiring rebubbling.
RESULTS
The third rebubbling procedure caused a traumatic PK wound dehiscence at the graft-host junction with full-thickness opening of approximately 180 degrees. PK wound dehiscence was resutured in the theater, DMEK lenticule was removed from the eye, and the full-thickness graft was repeated.
CONCLUSIONS
DMEK graft rebubbling in patients with previous PK may lead to traumatic wound dehiscence. Avoidance of excessive increases in intraocular pressure during the rebubbling procedure should be encouraged to decrease the risk of this rare complication.
目的
本研究旨在描述一种去内皮角膜移植术（DMEK）再次注气的罕见并发症。
方法
一名 86 岁女性，20 年前因 Fuchs 内皮营养不良行双眼穿透性角膜移植术（PK），左眼因角膜内皮失代偿行 DMEK 手术。术后出现多次 DMEK 移植物脱离，需要再次注气，手术变得复杂。
结果
第三次注气导致移植物与宿主交界处的 PK 伤口裂开，全层裂开约 180 度。在手术室进行 PK 伤口缝合，从眼睛中取出 DMEK 薄片，再次进行全层移植物。
结论
既往 PK 患者的 DMEK 移植物再次注气可能导致外伤性伤口裂开。应鼓励在再次注气过程中避免眼内压过度升高，以降低这种罕见并发症的风险。
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