Fernández-Vega-Cueto L, Lisa C, Vasanthananthan K, Madrid-Costa D, Alfonso J F, Melles G R J
Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain.
Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2023 Mar;98(3):170-174. doi: 10.1016/j.oftale.2022.11.006. Epub 2023 Feb 2.
Descemet Membrane detachment is a potential complication after Descemet Membrane Endothelial Keratoplasty (DMEK). Here, we present a unique case of a DMEK surgery in a complicated eye that suffered a nearly complete DMEK graft detachment and later a graft opacification with a pseudo-anterior chamber. In Mid-November 2020, a planned DMEK was performed in a 64-year-old male patient due to corneal decompensation. Four months after DMEK, a fibrotic DMEK graft was seen across the anterior chamber with a pseudo-anterior chamber; however, the recipient cornea showed complete clearance with an endothelial cell count of about 1204 cells/mm2 and a best-corrected visual acuity of 20/25. Three months later, we observed a significant opacification of the detached graft, and the best-corrected distance visual acuity decreased to 20/63. We proceeded with the graft removal without performing a second DMEK. Ten months after graft removal, the cornea remained clear with an endothelial cell count of about 510 cells/mm, and the best-corrected visual acuity was 20/25.
后弹力层脱离是后弹力层内皮角膜移植术（DMEK）后的一种潜在并发症。在此，我们报告一例复杂眼行DMEK手术的独特病例，该眼发生了几乎完全的DMEK植片脱离，随后出现植片混浊并伴有假性前房。2020年11月中旬，因角膜失代偿，为一名64岁男性患者实施了计划性DMEK手术。DMEK术后4个月，可见纤维化DMEK植片横跨前房并伴有假性前房；然而，受体角膜完全清亮，内皮细胞计数约为1204个细胞/mm²，最佳矫正视力为20/25。3个月后，我们观察到脱离的植片出现明显混浊，最佳矫正远视力降至20/63。我们未进行第二次DMEK手术，而是直接取出了植片。植片取出10个月后，角膜保持清亮，内皮细胞计数约为510个细胞/mm，最佳矫正视力为20/25。
