Ophthalmology, Dr Ashok Sharma's Cornea Centre, Chandigarh, UT, India
Cornea Service, Dr Ashok Sharma's Cornea Centre, Chandigarh, UT, India.
BMJ Case Rep. 2023 Aug 16;16(8):e253252. doi: 10.1136/bcr-2022-253252.
A woman in her 60s was referred to us for management of poor vision following cataract surgery in the right eye. She had undergone manual small incision cataract surgery 12 weeks earlier. Slit-lamp biomicroscopy revealed corneal oedema, a horizontal line at the upper border and the adhered inferior border of detached Descemet's membrane (DM). Clinical diagnosis of impacted Descemet's membrane detachment (DMD) was considered.Surgical intervention with manual schisis and intracameral injection of air was planned. Using the 'push technique,' we tried to place the tip of the 27 gauge cannula between the back of the cornea and detached DM. The tip of the 27 gauge cannula was behind the impacted DM, and air injection was unsuccessful. Using the back-up the 'pull technique,' bent tip of the 27 gauge cannula was used to pull the impacted DMD. This manoeuvre, disimpacted the inferior border and the air bubble, was injected using the 27 gauge cannula. The air bubble unfolded and reattached the DM successfully.
一位 60 多岁的女性因右眼白内障手术后视力不佳而被转来我院就诊。她在 12 周前接受了手动小切口白内障手术。裂隙灯生物显微镜检查显示角膜水肿，上方边界有一条水平线，下方边界有粘连的脱离的德斯梅特膜（DM）。临床诊断为嵌顿的德斯梅特膜脱离（DMD）。计划进行手动劈裂和前房内注气的手术干预。我们使用“推注技术”，试图将 27 号套管的尖端放在角膜后部和脱离的 DM 之间。27 号套管的尖端位于嵌顿的 DM 后面，注气不成功。使用备用的“拉注技术”，使用弯曲的 27 号套管尖端将嵌顿的 DMD 拉下来。这一操作使下方边界和气泡脱离，然后使用 27 号套管将气泡注入。气泡展开并成功地重新附着 DM。
