Annals of Optometry and Contact Lens 2020;19(3):72-77.
Published online September 25, 2020.
각막기질박리 중 발생한 데스메막 파열에서 시행한 심부표층각막이식술 1예
이상재, 박철용
동국대학교 일산병원 안과1,
동국대학교 의과대학 감각기관연구소2
Deep Anterior Lamellar Keratoplasty Performed in the Rupture of Descemet’s Membrane during Corneal Stroma Dissection
Sang Jae Lee, Choul Yong Park
Department of Ophthalmology, Dongguk University Ilsan Hospital1, Goyang, Korea
Sensory Organ Research Center, Dongguk University College of Medicine2, Gyeongju, Korea
Received: 10 June 2020   • Revised: 29 July 2020   • Accepted: 24 August 2020
Abstract
Purpose: To report a successful treatment of Descemet’s membrane detachment during deep anterior lamellar keratoplasty (DALK) through repeated air injections into the anterior chamber.
Case summary: A 57-year old woman underwent DALK for the treatment of central corneal opacity due to keratitis. After dissecting the recipient’s corneal stroma, Descemet’s membrane was detached through big bubble technique. Then, during the excision of residual corneal stroma with corneal scissors, a partial rupture of Descemet's membrane occurred. Because the rupture size was small (3 hours of meridian), DALK was continued. Air injection into the anterior chamber was performed to prevent detachment of the recipient’s descemet’s membrane. Next day, a localized folding of Descemet's membrane near the rupture area was observed with almost full air filling of the anterior chamber. Three days after the surgery, significant descemet’s membrane detachment with corneal edema developed and air filling of the anterior chamber was repeated. Thereafter, two additional anterior chamber air injections were repeated every three days. Finally, descemet’s membranes detachment was fully resolved with the restoration of corneal thickness and transparency.
Conclusions: Descemet’s membrane rupture during DALK and subsequent descemet’s membrane detachment can be successfully managed with repeated air injections into the anterior chamber as long as the size and location were favorable.
Key Words: Anterior chamber air injection; Corneal transplantation; Deep anterior lamellar keratoplasty; Descemet’s membrane detachment; Descemet’s membrane rupture
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