Cornea and Anterior Segment Services, L. J. Eye Institute, Ambala, Haryana, India.
Indian J Ophthalmol. 2023 Jan;71(1):281-286. doi: 10.4103/ijo.IJO_2085_22.
This article reports a novel surgical technique of partial-thickness compression sutures without descemetopexy with air or gas for the management of acute hydrops in keratoconus. Two patients presented with localized corneal edema with a Descemet membrane (DM) tear in the left eye. Tomography of the right eye revealed localized steepening with increased maximum keratometry and decreased central pachymetry. They were diagnosed with keratoconus in the right eye and acute corneal hydrops (ACH) in the left eye. Compression sutures were passed through the stroma without touching the DM. The anterior chamber was not entered at all at any point during the surgery. Resolution of edema was noted intraoperatively itself. Further resolution of edema was noted from the first postoperative day which markedly reduced within the first week. A corneal scar with no edema was seen at six weeks. In both the patients, vision at presentation was counting fingers close to face which improved to 20/60 and 20/50, respectively, at the last visit.
本文报道了一种新的手术技术，即不进行 Descemet 膜固定的部分厚度压缩缝合术，通过空气或气体来治疗圆锥角膜的急性水肿。两名患者左眼出现局限性角膜水肿伴 Descemet 膜（DM）撕裂。右眼的断层扫描显示局限性陡峭，最大角膜曲率增加，中央角膜厚度降低。他们被诊断为右眼圆锥角膜和左眼急性角膜水肿（ACH）。压缩缝线穿过基质，不触及 DM。在整个手术过程中，前房均未进入。术中即可观察到水肿消退。术后第一天水肿进一步消退，第一周内明显减轻。六周后可观察到角膜瘢痕无水肿。在这两名患者中，就诊时的视力均为近距手动，分别在最后一次就诊时提高到 20/60 和 20/50。
