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首页> 外文期刊>Case Reports in Ophthalmological Medicine >Modified Descemet’s Stripping Automated Endothelial Keratoplasty: The Use of Ophthalmic Viscoelastic Devices in Hypotonic Eyes That Had Undergone Glaucoma Filtering Surgeries
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Modified Descemet’s Stripping Automated Endothelial Keratoplasty: The Use of Ophthalmic Viscoelastic Devices in Hypotonic Eyes That Had Undergone Glaucoma Filtering Surgeries

机译：改良的Descemet剥离自动角膜内皮移植术：在进行过青光眼滤过手术的低渗眼中使用眼科粘弹性装置

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Purpose. Descemet’s stripping automated endothelial keratoplasty (DSAEK) is more difficult in hypotonic eyes with filtering bleb, due to the difficulties in elevating the intraocular pressure (IOP). We report a new method that uses ophthalmic viscoelastic devices (OVDs) to achieve good graft adhesion. Case Presentation. We performed modified DSAEK surgery on 2 eyes of 2 patients, who had previously undergone a trabeculectomy. Both eyes had functioning filtering blebs; the IOP was lower than 10 mmHg without medication. After the graft was inserted into the anterior chamber, the conjunctiva was penetrated, apart from the bleb, using a 30 G needle, and Healon V® was injected into the bleb until the encapsulated space was filled completely. Air was subsequently injected into the anterior chamber to promote the graft attachment to the back surface of the cornea. The IOP was elevated above 40 mmHg in both eyes 1 h after surgery and then decreased to less than 30 mmHg over the subsequent 3 h period. The implanted graft showed good adhesion and no dislocation. Conclusions. Our novel DSAEK procedure that adds one step of OVD injection into the filtering bleb may be useful for hypotonic eyes that had undergone filtering surgeries.
机译：目的。由于低眼压（IOP）升高，在具有滤过泡的低渗眼中，Descemet的剥离自动内皮角膜移植术（DSAEK）更加困难。我们报告了一种新的方法，该方法使用眼科粘弹性器件（OVD）来实现良好的移植物粘附。案例介绍。我们对2例先前曾做过小梁切除术的患者的2眼进行了改良DSAEK手术。两只眼睛都有功能正常的滤泡。没有药物治疗的眼压低于10μgHg。将移植物插入前房后，使用30 G针将结膜从小泡中穿透出来，然后将HealonV®注入小泡中，直到完全包封包埋的空间。随后将空气注入前房，以促进移植物附着到角膜后表面。手术后1 h，两只眼睛的IOP升高至40 mmHg以上，然后在随后的3 h期间降至低于30 mmHg。植入的移植物显示出良好的粘附力，并且没有脱位。结论。我们新颖的DSAEK程序将OVD注射步骤增加了一个到滤过泡中，这可能对经过滤过手术的低渗眼有用。

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