Visibility of the Retina Through an Air-Filled Anterior Chamber During Simultaneous Vitrectomy and Descemet's Stripping Automated Endothelial Keratoplasty
Visibility of the Retina Through an Air-Filled Anterior Chamber During Simultaneous Vitrectomy and Descemet's Stripping Automated Endothelial Keratoplasty
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DOI：
10.2147/opth.s262403
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发表时间：
2020-01-01
影响因子：
2.2
通讯作者：
Sugiyama, Kazuhisa
中科院分区：
文献类型：
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作者：
Yokogawa, Hideaki;Kobayashi, Akira;Sugiyama, Kazuhisa
目的：描述在同时进行玻璃体切除（PPV）和Descemet剥离自动内皮角膜移植术（DSAEK）时，通过充满空气的前房的视网膜可见性，并讨论在这种情况下流体-空气交换的技术挑战。方法：6例大疱性角膜病变合并玻璃体混浊、硅油残留、晶状体半脱位、无晶状体等后段问题的患者，6只眼同时行PPV和DSAEK。在所有病例中，在完成25号PPV伴/不伴带状巩膜内人工晶状体固定后，将DSAEK供体组织插入前房。然后将空气注入前房，将供体移植物附着在宿主角膜的后表面。此时，使用内照度和广角观察系统评估视网膜的可见性。结果：在所有病例中，视网膜通过充满空气的前房可见，与DSAEK供体相连，足以进行液体-空气交换。结论：我们对这种罕见但临床上重要的疾病的临床观察表明，PPV和DSAEK同时进行是可能的，包括视网膜在内的后段可见。
Purpose: To describe the visibility of the retina through an air-filled anterior chamber during simultaneous pars plana vitrectomy (PPV) and Descemet's stripping automated endothelial keratoplasty (DSAEK), and to discuss the technical challenges of a fluid-air exchange under such conditions.Methods: Six eyes from 6 patients with coexisting bullous keratopathy and posterior segment problems such as vitreous opacity, retained silicon oil, intraocular lens subluxation, or aphakia underwent simultaneous PPV and DSAEK. In all cases, after completion of 25-gauge PPV with/without flanged intrascleral intraocular lens fixation, DSAEK donor tissue was inserted into the anterior chamber. Air was then injected into the anterior chamber to attach the donor graft to the back surface of the host cornea. At this point, the visibility of the retina was evaluated using endoillumination and a wide-angle viewing system.Results: In all cases, visibility of the retina through an air-filled anterior chamber, with the DSAEK donor attached, was sufficient to perform a fluid-air exchange.Conclusion: Our clinical observations of such rare but clinically important conditions indicate that simultaneous PPV and DSAEK is possible with fair visualization of the posterior segment including the retina.