KMID : 0360220140550030449
|
|
Journal of the Korean Ophthalmological Society 2014 Volume.55 No. 3 p.449 ~ p.453
|
|
A Case of Double Descemet¡¯s Membrane after Penetrating Keratoplasty Converted from Deep Anterior Lamellar Keratoplasty
|
|
Im Jong-Chan
Kim Hong-Kyun Lee Jun-Hun
|
|
Abstract
|
|
|
Purpose: To report a case of double Descemet¡¯s membrane in a patient who had penetrating keratoplasty after rupture of Descemet¡¯s membrane during deep anterior lamellar keratoplasty (DALK).
Case summary: A 24-year-old female had keratoconus in her right eye and underwent DALK for treatment. Descemet¡¯s membrane was ruptured while separating the corneal stroma from Descemet¡¯s membrane with the big bubble technique. The operation method was changed from DALK to penetrating keratoplasty. Detached Descemet¡¯s membrane was observed in the anterior chamber after suturing. Sterile air was injected into the anterior chamber to attach the Descemet¡¯s membrane. Five days after the surgery, Descemet¡¯s membrane was detached and a second air injection was performed. Corneal edema was improved but Descemet¡¯s membrane was re-detached. Double Descemet¡¯s membrane was observed by anterior segment optical coherence tomography (OCT). The detached Descemet¡¯s membrane originated from the recipient¡¯s cornea and not from the donor¡¯s cornea. Detached Descemet¡¯s membrane was removed successfully. Patient¡¯s cornea was clear and best corrected visual acuity was 20/25.
Conclusions: When penetrating keratoplasty is performed instead of DALK, the surgeon should completely remove the remnant corneal stroma and Descemet¡¯s membrane. Remnant Descemet¡¯s membrane can be disregarded as it comes from the donor cornea. Unnecessary anterior chamber air injection causes endothelial damage. Anterior segment OCT is a useful tool to identify anatomical structures of transplanted cornea.
|
|
KEYWORD
|
|
Anterior segment OCT, DALK, Double Descemet¡¯s membrane, PKP
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|