Ghazal Wassim, Duvillier Amélie, Panthier Christophe, Saad Alain, Gatinel Damien
Department of Ophthalmology, Rothschild Foundation Hospital, 25, Rue Manin, 75019, Paris, France.
CEROC (Center of Expertise and Research in Optics for Clinicians), Paris, France.
Am J Ophthalmol Case Rep. 2023 Jun 29;32:101882. doi: 10.1016/j.ajoc.2023.101882. eCollection 2023 Dec.
We describe a combined Descemet Membrane Endothelial Keratoplasty (DMEK) using the Cornea-press (C-Press) technique, with implantation of a new sutureless, scleral fixated intraocular lens (IOL) (Carlevale, Soleko), in a case of bullous keratopathy and IOL mispositioning.
Two scleral pockets were created along two scleral radial incisions, 180° apart, followed by two 23 G sclerotomies at the pockets' sites. After removal of the dislocated IOL through a corneoscleral incision, posterior vitrectomy was completed. The Carlevale IOL was injected into the anterior chamber (AC) and placed above the iris. The haptics were then externalized using opening distal forceps through the sclerotomies, and the plugs were secured in the scleral pockets. DMEK was then performed using the "C-press" technique, where corneal indentation allowed to artificially shallow the AC to ensure successful graft unrolling. Fifteen months postoperatively, the cornea was clear, the Carlevale IOL well positioned, and the patient's vision improved.
DMEK using the C-Press technique, combined with a sutureless, scleral-fixated IOL such as the Carlevale in a single procedure, may be a safe and effective option to restore vision in case of bullous keratopathy and dislocated IOL.
我们描述了一种在大疱性角膜病变合并人工晶状体（IOL）移位的病例中，使用角膜按压（C-Press）技术进行的联合Descemet膜内皮角膜移植术（DMEK），并植入一种新型无缝线、巩膜固定的人工晶状体（Carlevale，Soleko）。
沿着两条相距180°的巩膜放射状切口制作两个巩膜袋，然后在袋的部位进行两个23G巩膜切开术。通过角巩膜切口取出脱位的人工晶状体后，完成后段玻璃体切除术。将Carlevale人工晶状体注入前房（AC）并置于虹膜上方。然后使用开放远端镊子通过巩膜切开术将襻引出，并将塞子固定在巩膜袋中。然后使用“C按压”技术进行DMEK，通过角膜压陷使前房人为变浅，以确保移植物成功展开。术后15个月，角膜透明，Carlevale人工晶状体位置良好，患者视力改善。
在单一手术中，使用C-Press技术进行DMEK，并联合使用如Carlevale这样的无缝线、巩膜固定人工晶状体，可能是恢复大疱性角膜病变和人工晶状体脱位患者视力的一种安全有效的选择。
