Gharra Muhammad, Achiron Assaf, Naftali Ben Haim Liron, Avizemer Haggay
Department of Ophthalmology, Edith Wolfson Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Am J Ophthalmol Case Rep. 2022 Feb 12;26:101290. doi: 10.1016/j.ajoc.2022.101290. eCollection 2022 Jun.
Early postoperative graft detachment remains one of the most common complications of DSAEK.
To describe a modification of a simple method to facilitate a firm AC, without a leak, during DSAEK.
Ten consecutive DSAEK surgeries were reviewed. Surgery was performed by a single surgeon (HA). At the beginning of surgery, a trapezoid paracentesis was made at the limbus using a 20G MVR blade. The trapezoid incision was made by inserting the blade halfway, creating a cut with an internal opening half the width of its external opening. After inserting the corneal disc and suturing the main incision, air was injected with a 25G tapered hydrodelineation cannula. The tip was engaged at the trapezoid paracentesis and did not enter the anterior chamber. A firm, full air bubble was formed in the anterior chamber, and no leaking occurred at the paracentesis site, which acted as a one-way valve.
All grafts were adhered from the first day after surgery, and no dislocations were observed. All corneas were clear at the one-month postoperative visit.
Wound-assisted air injection is a safe, effective, simple method for achieving a firm air bubble during DSAEK, potentially reducing dislocation rates.
术后早期植片脱离仍然是深板层角膜内皮移植术（DSAEK）最常见的并发症之一。
描述一种改良的简单方法，以在DSAEK手术期间促进前房牢固形成且无渗漏。
回顾了连续10例DSAEK手术。手术由单一外科医生（HA）进行。手术开始时，使用20G MVR刀片在角膜缘做一个梯形穿刺口。通过将刀片插入一半深度来制作梯形切口，形成一个内开口宽度为外开口一半的切口。插入角膜片并缝合主切口后，用25G锥形水分离套管注入空气。尖端置于梯形穿刺口处，未进入前房。在前房形成了一个牢固、完整的气泡，穿刺口处无渗漏，该穿刺口起到了单向瓣膜的作用。
所有植片在术后第一天均已附着，未观察到脱位情况。术后1个月时所有角膜均透明。
伤口辅助空气注入是一种在DSAEK手术期间实现牢固气泡的安全、有效、简单的方法，可能会降低脱位率。
