Gad Rania E, Kahn Jonathan, Trief Danielle
Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA.
Ophthalmology Department, Helwan University, Cairo, Egypt.
Case Rep Ophthalmol. 2024 Jan 12;15(1):41-46. doi: 10.1159/000535402. eCollection 2024 Jan-Dec.
This is a case report of a spontaneous reattachment of Descemet-stripping automated endothelial keratoplasty (DSAEK). This graft was primarily sutured, and 20% sulfur hexafluoride (SF6) was injected into the anterior chamber, followed by graft detachment and spontaneous reattachment, 3 months later.
A 78-year-old male presented with DSAEK graft detachment, which was the patient's second DSAEK (the first also did not adhere). During the second surgery, the DSAEK graft was sutured and 20% SF6 was injected intraoperatively. Graft reattachment occurred without any intervention or repositioning 3 months after the 2nd DSAEK surgery.
Spontaneous DSEAK late graft reattachment is possible, particularly in the setting of an anchoring suture. In some patients, waiting can be an option that can spare the patient the possible risks of graft repositioning, rebubbling, or repeating the DSAEK. Suturing the DSAEK graft primarily may have served as an anchor to keep the graft approximate and aid in attachment. A graft suture can be considered in the setting of a previously failed DSAEK due to DSAEK graft detachment.
本文是一篇关于Descemet膜剥脱自动内皮角膜移植术(DSAEK)自发重新附着的病例报告。该移植物最初进行了缝合,并向前房内注射了20%的六氟化硫(SF6),3个月后移植物发生脱离并自发重新附着。
一名78岁男性患者出现DSAEK移植物脱离,这是该患者的第二次DSAEK手术(第一次手术时移植物也未附着)。在第二次手术中,对DSAEK移植物进行了缝合,并在术中注射了20%的SF6。第二次DSAEK手术后3个月,移植物在没有任何干预或重新定位的情况下实现了重新附着。
DSAEK移植物晚期自发重新附着是可能的,尤其是在有固定缝线的情况下。对于一些患者,等待可能是一种选择,这样可以避免患者面临移植物重新定位、再次注气或重复DSAEK手术可能带来的风险。最初对DSAEK移植物进行缝合可能起到了固定作用,使移植物保持接近并有助于附着。对于因DSAEK移植物脱离导致先前DSAEK手术失败的情况,可以考虑进行移植物缝合。