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白内障手术顺利完成后迟发性后弹力层脱离

Late Descemet membrane detachment after uneventful cataract surgery.

作者信息

Trindade Lovaglio Cançado, Attanasio de Rezende Renata, Bisol Tiago, J Rapuano Christopher

机构信息

Medical Sciences Medical School-FELUMA, Belo Horizonte, Brazil.

Medical Sciences Eye Institute-FELUMA, Belo Horizonte, Brazil.

出版信息

Am J Ophthalmol Case Rep. 2022 Dec 23;29:101783. doi: 10.1016/j.ajoc.2022.101783. eCollection 2023 Mar.

Abstract

PURPOSE

To report 5 patients with late Descemet membrane (DM) detachment after uneventful cataract surgery.

OBSERVATIONS

After a retrospective chart analysis of consecutive patients that developed DM detachment after uneventful cataract surgery, six eyes of five patients were enrolled. In all cases, patients reported good vision initially after cataract surgery. Within days to months, these patients developed late DM detachment with decreased vision. In one patient, the detachment affected both eyes. Filtered air or diluted sulfur hexafluoride were injected in the anterior chamber to tamponade the DM detachment. In five eyes, the cornea cleared after DM reattachment. In two eyes of the same patient, DM reattached spontaneously requiring no further surgical intervention. In one patient, the Descemet failed to reattach and required an endothelial keratoplasty.

CONCLUSION AND IMPORTANCE

Descemet membrane detachment may occur after uneventful cataract surgery. Filtered air or long-lasting intraocular gas may be used to reattach DM. Spontaneous DM reattachment may also occur and surgeons should be aware of this to avoid unnecessary procedures.

摘要

目的

报告5例白内障手术顺利后发生迟发性后弹力层(DM)脱离的患者。

观察结果

对白内障手术顺利后发生DM脱离的连续患者进行回顾性病历分析后,纳入了5例患者的6只眼。所有病例中,患者白内障手术后最初视力良好。在数天至数月内,这些患者发生了迟发性DM脱离,视力下降。1例患者双眼均受影响。向前房内注入过滤空气或稀释的六氟化硫以填塞DM脱离。5只眼中,DM重新附着后角膜恢复透明。同一患者的2只眼,DM自发重新附着,无需进一步手术干预。1例患者,后弹力层未能重新附着,需要进行内皮角膜移植术。

结论及重要性

白内障手术顺利后可能发生后弹力层脱离。可使用过滤空气或长效眼内气体使DM重新附着。DM也可能自发重新附着,外科医生应意识到这一点以避免不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5934/9827023/cc62004a0a8f/gr1.jpg

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