Contact Lens-Assisted DMEK for Corneal Decompensation With an Anterior Chamber Intraocular Lens: A Novel Technique.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2024-12-01 Epub Date: 2024-06-26 DOI:10.1097/ICO.0000000000003606

Reginald Robert G Tan

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引用次数: 0

Abstract

Purpose: To describe a novel technique in which a contact lens was used to facilitate Descemet membrane endothelial keratoplasty (DMEK) in an eye with an anterior chamber intraocular lens (ACIOL).

Methods: A 71-year-old man with a long-standing ACIOL developed bullous keratopathy. As the patient was at high risk of complications due to multiple ocular comorbidities, DMEK was performed with the ACIOL left in the anterior chamber. An inserted cosmetic contact lens was used as a platform for the graft unfolding.

Results: Partial graft detachment on the third postoperative day required rebubbling. This successfully cleared up the cornea after a few weeks. At the one-month follow-up, the uncorrected distance visual acuity improved to 20/50, with an endothelial cell loss of 35.2%. Steroid-induced ocular hypertension necessitated a trabeculectomy by the fifth postoperative month. At the sixth follow-up month, endothelial cell loss was 64%.

Conclusions: Contact lens-assisted DMEK is a safe procedure for eyes with an ACIOL. However, good foresight is needed regarding whether the ACIOL should be kept or exchanged.

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使用前房型眼内透镜辅助角膜屈光手术（DMEK）治疗角膜失代偿：一项新技术。

目的：描述一种新技术，即使用隐形眼镜促进戴有前房型眼内透镜（ACIOL）的眼睛进行德斯密特膜内皮角膜移植术（DMEK）：一名 71 岁的男子因长期佩戴 ACIOL 而患上了牛皮状角膜病。由于患者患有多种眼部并发症，并发症风险很高，因此在进行 DMEK 手术时，将 ACIOL 保留在前房中。插入的美容隐形眼镜被用作移植物展开的平台：结果：术后第三天，部分移植物脱落，需要重新注泡。结果：术后第三天，移植物部分脱落，需要重新注泡，几周后，角膜成功清理干净。随访一个月后，未矫正的远距离视力提高到了 20/50，内皮细胞损失率为 35.2%。类固醇引起的眼压升高使得患者必须在术后第五个月进行小梁切除术。在术后第六个月的随访中，内皮细胞丢失率为64%：结论：隐形眼镜辅助的 DMEK 对于有 ACIOL 的眼睛来说是一种安全的手术。结论：隐形眼镜辅助 DMEK 手术对带有 ACIOL 的眼睛是安全的，但对于是否应保留或更换 ACIOL 需要有良好的预见性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.