Gab-Alla Amr A
Ophthalmology Department, Suez Canal University, Faculty of Medicine, Ismailia, Egypt.
J Ophthalmol. 2021 Jul 6;2021:9953418. doi: 10.1155/2021/9953418. eCollection 2021.
To compare the efficacy of air bubble tamponade alone versus air bubble tamponade with internal fluid aspiration for nonplanar Descemet's membrane detachment after clear corneal incision phacoemulsification.
This study is a prospective, intervention, comparative randomised clinical trial, conducted at a private eye centre, Ismailia, Egypt, from March 2019 to March 2020. It contained 30 eyes of 24 patients who had postphacoemulsification nonplanar Descemet's membrane detachment involving the periphery and the central area of the cornea (>50% of the cornea) with corneal oedema. The patients were divided into two groups: group A: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade only and group B: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade augmented by internal fluid aspiration. : This trial was registered at www.pactr.org and the identification number for the registry is PACTR202006612296119.
During the 12-month study period, this study included 30 eyes (24 patients) out of 1356 phaco surgeries with postphacoemulsification nonplanar Descemet's membrane detachment. Six patients had DMD in both eyes, eight patients had DMD in the right eye, and ten patients had DMD in the left eye. All patients have successful surgeries without complications. The calculated incidence rate for visually significant DMD was 2.2% per year. The mean ± SD time interval from cataract surgery to the primary intervention was 4.2 ± 1.1 days. Descemet's membrane was attached in 56.25% of patients in group A (9 out of 16 eyes) and 92.6% of patients in group B (13 out of 14 eyes) with a minimum of one-month follow-up.
Air descemetopexy combined with the internal fluid aspiration demonstrated to be more efficient than air descemetopexy only to treat Descemet's membrane detachment following phacoemulsification. It should be tried before planning other major surgeries in patients with severe Descemet's membrane detachment.
比较单纯空气泡填塞与空气泡填塞联合内部液体抽吸治疗透明角膜切口白内障超声乳化术后非平面性Descemet膜脱离的疗效。
本研究是一项前瞻性、干预性、比较随机临床试验，于2019年3月至2020年3月在埃及伊斯梅利亚的一家私立眼科中心进行。研究纳入了24例患者的30只眼，这些患者在白内障超声乳化术后发生了累及角膜周边和中央区域（>角膜的50%）并伴有角膜水肿的非平面性Descemet膜脱离。患者被分为两组：A组：仅采用空气泡填塞治疗累及中央角膜的非平面性Descemet膜脱离的患者；B组：采用空气泡填塞联合内部液体抽吸治疗累及中央角膜的非平面性Descemet膜脱离的患者。本试验已在www.pactr.org注册，注册号为PACTR202006612296119。
在为期12个月的研究期间，本研究纳入了1356例白内障超声乳化手术中发生术后非平面性Descemet膜脱离的30只眼（24例患者）。6例患者双眼发生Descemet膜脱离，8例患者右眼发生Descemet膜脱离，10例患者左眼发生Descemet膜脱离。所有患者手术均成功，无并发症。计算得出具有视觉意义的Descemet膜脱离的发生率为每年2.2%。从白内障手术到首次干预的平均±标准差时间间隔为4.2±1.1天。在至少1个月的随访中，A组56.25%的患者（16只眼中的9只）Descemet膜附着，B组92.6%的患者（14只眼中的13只）Descemet膜附着。
空气Descemet膜固定术联合内部液体抽吸治疗白内障超声乳化术后Descemet膜脱离比单纯空气Descemet膜固定术更有效。对于严重Descemet膜脱离的患者，在计划其他大型手术之前应尝试这种方法。
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