Li Fan, Zhu Zhe, Fan Lubo, Yi Gengrong, Zhu Xiaowei, Li Naiyang
Eye Center, Zhongshan City People's Hospital, Zhongshan 528403, China.
Department of Medicine, Division of Regenerative Medicine, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA.
J Clin Med. 2022 Nov 27;11(23):7001. doi: 10.3390/jcm11237001.
Our study aims to investigate a simple repair algorithm for Descemet's membrane detachment (DMD) following phacoemulsification with Pentacam and anterior segment optical coherence tomography (AS-OCT). Twelve patients with DMD were included in this retrospective study. All cases had persistent corneal edema after phacoemulsification and no improved response to conservative treatment. The repair algorithm consisted of delineating the DMD with the Pentacam and AS-OCT, paracentesis, and intracameral air bubble performed at the slit lamp, followed by immediate supine position. At one month, the final status of Descemet's membrane (DM), best-corrected visual acuity, and incidence of complications were noted. DMD was involved in the visual axis in all cases. The mean interval between phacoemulsification and repair was 5.3 ± 1.2 days. Complete reattachment of DM and corneal clarity occurred in all 12 eyes. Eleven (91.7%) eyes underwent one repair procedure, while one eye (8.3%) underwent a repeat procedure. No adverse events were found. Minor post-intervention complications included temporary increased intraocular pressure due to pupillary block in one eye (8.3%). In conclusion, our modified and simplified repair algorithm for DMD can be performed safely as an outpatient procedure, with accurate delineation using a Pentacam and AS-OCT. It may provide new insight into the timely diagnosis, evaluation, and management of DMD.
我们的研究旨在利用Pentacam和眼前节光学相干断层扫描（AS-OCT），研究一种用于白内障超声乳化术后Descemet膜脱离（DMD）的简单修复算法。本回顾性研究纳入了12例DMD患者。所有病例在白内障超声乳化术后均有持续性角膜水肿，且对保守治疗无改善反应。该修复算法包括使用Pentacam和AS-OCT描绘DMD，在裂隙灯下进行前房穿刺和前房内注入气泡，然后立即采取仰卧位。在1个月时，记录Descemet膜（DM）的最终状态、最佳矫正视力和并发症发生率。所有病例的DMD均累及视轴。白内障超声乳化术与修复之间的平均间隔时间为5.3±1.2天。所有12只眼的DM均完全重新附着，角膜恢复透明。11只眼（91.7%）进行了一次修复手术，1只眼（8.3%）进行了重复手术。未发现不良事件。干预后轻微并发症包括1只眼（8.3%）因瞳孔阻滞导致眼压暂时升高。总之，我们改良和简化的DMD修复算法可作为门诊手术安全进行，使用Pentacam和AS-OCT可进行准确描绘。它可能为DMD的及时诊断、评估和管理提供新的见解。
