Cheung Albert Y, de la Presa Martin, Silverberg Marc L, Quiroz-Casian Natalia, Holland Edward J
Virginia Eye Consultants, Norfolk, VA.
Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA.
Cornea. 2025 Jan 8;44(6):795-798. doi: 10.1097/ICO.0000000000003802.
To describe a technique involving combined endothelialectomy and trypan blue staining to allow for improved visualization and Descemet membrane (DM) removal during endothelial keratoplasty.
Endothelialectomy with 2 disposable endothelial irrigating cannulas (Vortex and Sterimedix) and an irrigation-aspiration handpiece are described. Several passes over the desired area are made to ensure adequate endothelialectomy treatment. Trypan blue is instilled into the anterior chamber, and after irrigation, the trypan stains the exposed DM, which enhances visualization. Subsequently, one's standard technique for descemetorhexis can then be performed.
Endothelialectomy with trypan blue staining was performed in 9 eyes and was able to successfully enhance visualization of DM in all cases. The technique easily allowed for visualization of the descemetorhexis edge despite the poor view. Although all 3 instruments for endothelialectomy allowed for successful descemetorhexis, the Vortex endothelial cannula provided more complete and consistent endothelialectomy with fewer passes. The descemetorhexis tissue from 1 case using the Sterimedix cannula was sent for histological review and demonstrated a paucity of endothelial cells, intact DM, and blunted guttae.
Targeted endothelialectomy and trypan blue staining can be a useful technique to enhance visualization during endothelial keratoplasty. This can allow for a more complete descemetorhexis in areas with marginal visibility.
描述一种联合内皮切除术和台盼蓝染色的技术，以在角膜内皮移植术中改善视野并去除后弹力层（DM）。
描述了使用2个一次性内皮冲洗套管（Vortex和Sterimedix）和一个灌注抽吸手柄进行内皮切除术。在所需区域进行多次操作以确保充分的内皮切除术治疗。将台盼蓝注入前房，冲洗后，台盼蓝会对暴露的DM进行染色，从而增强视野。随后，可以进行标准的后弹力层撕除技术。
对9只眼进行了台盼蓝染色的内皮切除术，所有病例均成功增强了DM的视野。尽管视野不佳，该技术仍能轻松观察到后弹力层撕除边缘。尽管所有3种内皮切除器械都能成功进行后弹力层撕除，但Vortex内皮套管只需较少的操作次数就能提供更完整、更一致的内皮切除术。使用Sterimedix套管的1例病例的后弹力层撕除组织送去进行组织学检查，结果显示内皮细胞稀少、DM完整且角膜小滴变钝。
靶向内皮切除术和台盼蓝染色可能是一种在角膜内皮移植术中增强视野的有用技术。这可以在视野边缘区域实现更完整的后弹力层撕除。
