Chow Jun Yong, Akhtar Ali Ahmad Nurfahmi, Bastion Mae-Lynn Catherine
Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Ophthalmology, Hospital Tengku Ampuan Afzan, Kuantan, MYS.
Cureus. 2021 Aug 7;13(8):e16985. doi: 10.7759/cureus.16985. eCollection 2021 Aug.
A 75-year-old man with underlying left eye idiopathic orbital inflammatory disease and bilateral glaucoma suspect with cup disc ratio 0.7 underwent right eye phacoemulsification. Intraoperatively, Descemet tear and Descemet membrane detachment (DMD) occurred. Pneumodescemetopexy with air bubble was performed. His vision remained counting fingers and the cornea was oedematous three weeks after the operation. Anterior segment optical coherence tomography (ASOCT) showed extensive (80%) rhegmatogenous DMD with planar edge and a maximum of 460 micrometers separation from the stroma. Pneumodescemetopexy with low concentration perfluoropropane (10% C3F8) was performed together with postoperative positioning. On day five post-pneumodescemetopexy, his vision improved to 6/9, the cornea cleared with mild Descemet striae, and the gas bubble reduced to 30% fill. There was no DMD detected on ASOCT. His vision remained 6/9 and the residual gas bubble was 15% in the anterior chamber at two weeks post-pneumodescemetopexy. This case report suggests that pneumodescemetopexy with 10% C3F8 successfully reattached the large nonplanar rhegmatogenous DMD.
一名75岁男性,左眼患有特发性眼眶炎性疾病,双眼疑似青光眼,杯盘比为0.7,接受了右眼白内障超声乳化手术。术中发生了后弹力层撕裂和后弹力层脱离(DMD)。进行了气泡注入式后弹力层固定术。术后三周,其视力仍为指数,角膜水肿。眼前节光学相干断层扫描(ASOCT)显示广泛(80%)的孔源性DMD,边缘呈平面状,与基质的最大分离距离为460微米。采用低浓度全氟丙烷(10% C3F8)进行气泡注入式后弹力层固定术并结合术后体位摆放。气泡注入式后弹力层固定术后第5天,其视力提高到6/9,角膜清亮,有轻度后弹力层条纹,气泡填充率降至30%。ASOCT未检测到DMD。气泡注入式后弹力层固定术后两周,其视力仍为6/9,前房残留气泡为15%。本病例报告表明,10% C3F8气泡注入式后弹力层固定术成功地使大型非平面孔源性DMD重新附着。