Eguchi Mami, Sakaguchi Hirokazu, Shiraki Akihiko, Soma Takeshi, Miki Atsuya, Nishida Kohji
Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Ophthalmology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan.
Am J Ophthalmol Case Rep. 2022 Jun 18;27:101623. doi: 10.1016/j.ajoc.2022.101623. eCollection 2022 Sep.
To present a novel microscope-integrated optical coherence tomography (iOCT)-guided surgical technique wherein Descemet's membrane detachment (DMD), occurring during vitrectomy, was treated intraoperatively in a patient who had previously undergone Descemet's stripping automated endothelial keratoplasty (DSAEK).
The surgical technique was performed on a 75-year-old man with a history of DSAEK to intraoperatively treat DMD, which occurred during vitrectomy in the left eye. A fine needle mounted on a syringe was inserted into the supra-Descemet's space under iOCT guidance. The location of the needle was easily identified by its high reflection. The interface fluid was safely aspirated under excellent visualization of the needle tip and the interface. Successful aspiration of the interface fluid was confirmed via iOCT imaging at the end of the surgery. The graft has remained well attached to the cornea throughout the one-year postoperative follow-up.
iOCT-guided surgical interventions provide a safe and accurate approach for treating intraoperative complications in eyes with a history of DSAEK.
介绍一种新型的显微镜集成光学相干断层扫描（iOCT）引导的手术技术，在一名先前接受过Descemet膜剥脱自动内皮角膜移植术（DSAEK）的患者中，术中治疗玻璃体切除术中发生的Descemet膜脱离（DMD）。
对一名有DSAEK病史的75岁男性进行了该手术技术，以术中治疗左眼玻璃体切除术中发生的DMD。在iOCT引导下，将安装在注射器上的细针插入Descemet膜上方的空间。通过其高反射很容易确定针的位置。在针尖和界面清晰可见的情况下，安全地吸出界面液。手术结束时通过iOCT成像确认成功吸出界面液。在术后一年的随访中，移植片一直与角膜保持良好附着。
iOCT引导的手术干预为治疗有DSAEK病史的眼睛术中并发症提供了一种安全、准确的方法。
